A trained practitioner will perform a Dix-Hallpike test on you. How is BPPV diagnosed?Ī typical doctor’s office visit will begin with a history of how the dizziness began and what the dizziness feels like. Secondary represents about 30% – 50% of BPPV and is most commonly associated with a preceding head trauma.1,2 It can also be in conjunction with Ménière’s disease, vestibular migraines and labyrinthitis. Primary or Idiopathic BPPV accounts for the majority of cases (50% – 70%).² Patients will be diagnosed with primary or idiopathic BPPV when it is found in isolation and without a preceding trauma. Patients with cupulolithiasis can present with an apogeotropic nystagmus with no latency. This is seen as less common than canalithiasis (less than 5%) and typically affects the lateral canals.² Nystagmus and dizziness are very intense and persistent when the cupula is in a non-horizontal position.

In cupulolithiasis, the particles adhere to the cupula in one of the canals. However, canalithiasis in the anterior and lateral canals will present with a different vector of nystagmus. Patients with posterior canal canalithiasis will typically present with a geotropic nystagmus that fatigues with repetitive provocation. This is due to the posterior canal being the most gravity-dependent part of the inner ear.² These small endolymph debris move when the head is repositioned causing vertigo. This is seen as the most common cause of BPPV and tends to affect the posterior semicircular canal most often. This term refers to the free-floating particles of endolymph debris that move through the semicircular canal fluids. Some patients may suffer from both of these at the same time but that is less common. Head trauma is also the most common cause of bilateral BPPV.¹ What causes BPPV?īPPV can be broken down into two different causes: canalithiasis or cupulolithiasis. However, younger individuals can experience BPPV as well but typically have a preceding head trauma. Who is affected by BPPV?īPPV most commonly affects those over the age of 50 and typically affects women more so than men. BPPV is one of the most common diagnoses causing dizziness among the general population.

This condition is typically associated with aging or a head injury but sometimes can onset without any particular cause. A nystagmus is when your eyes rapidly move uncontrollably. Typically these symptoms are aggravated by a change in head position causing the crystals to move triggering an eye movement known as a “nystagmus”. Symptoms can be intermittent lasting for sometimes up to a minute. As the name suggests, it is considered a benign condition caused by positional changes with your head. These small crystals moving out of place can cause you to feel dizziness and like the world is spinning around you. What is Benign Paroxysmal Positional Vertigo (BPPV) and is it serious?īPPV is a type of vertigo caused by small crystals of calcium moving in your inner ear (semicircular canals).

At home epley maneuvers for vertigo