Benign Paroxysmal Vertigo (BPV)

Benign positional vertigo, also known as benign paroxysmal positional vertigo (BPV or BPPV), is a common vestibular disorder caused by sudden attacks of dizziness when changing head position.

 

The dizziness typically occurs when getting up or lying down from a lying or sitting position and usually lasts only a few seconds to minutes. Although benign positional vertigo can be very uncomfortable, it is usually harmless and can be treated well.

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The cause of benign positional vertigo is a disturbance of the sense of balance in the inner ear, particularly the crystal sensory cells in the semicircular canals, which are responsible for perceiving head positions and movements. When these crystals become dislodged from their normal position and wander around the canals, they can interfere with head movements and cause dizziness.

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Symptoms of benign positional vertigo include sudden dizzy spells accompanied by nausea or vomiting. The dizziness is usually short-lived and occurs when the head is placed in a certain position. Dizziness may also be accompanied by a feeling of disorientation or a loss of balance.

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Diagnosis of benign positional vertigo is usually made by a doctor or neurologist, who takes a thorough medical history and performs a physical exam to rule out other possible causes of the vertigo. In addition, video nystagmography (VNG) may be done to monitor eye movements during the vertigo attack.

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Benign positional vertigo is usually treated by means of special positioning maneuvers in which the head is brought into certain positions in order to remove the disturbing crystals from the balance system. These maneuvers are typically performed by a trained physician or physical therapist and may require multiple sessions to be fully effective. In some cases, drug therapy such as betahistine or benzodiazepines may also be prescribed to relieve dizziness.

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Benign positional vertigo was first described in the 1950s by the French ENT doctor Barany and later investigated further by other researchers. Today it is a well-known vestibular disorder that is usually well managed and does not have serious long-term effects.