BENIGN PAROXYSMAL POSITIONAL VERTIGO
Benign paroxysmal positional vertigo is the most common cause (20–40%) of peripheral vertigo. Age of onset 11–84 years; mean age of onset fourth to fifth decades. Incidence increases with age.Slightly increased incidence in females.
- Most common are closed head injury and vestibular neuronitis (vertigo lasting days)
- Old age
- Surgery (stapedectomy or nonotologic)
- Prolonged bed rest and inactivity
- Benign paroxysmal positional vertigo can develop in cases of Ménière’s disease, viral labyrinthitis and recurrent vestibulopathy.
The ear’s role
Inside your ear is a tiny organ called the vestibular labyrinth. It includes three loop-shaped structures (semicircular canals) that contain fluid and fine, hair-like sensors that monitor the rotation of your head.
Other structures (otolith organs) in your ear monitor movements of your head — up and down, right and left, back and forth — and your head’s position related to gravity. These otolith organs contain crystals that make you sensitive to gravity.
For a variety of reasons, these crystals can become dislodged. When they become dislodged, they can move into one of the semicircular canals — especially while you’re lying down. This causes the semicircular canal to become sensitive to head position changes it would normally not respond to, which is what makes you feel dizzy.
Otoconia gets displaced from utricle to semicircular canal (SCC) usually posterior.
Cupulolithiasis: Deposition of otoconia on the cupula of posterior SCC.
Canalithiasis: Free floating material (debris) within the lumen of posterior SCC
- Sudden brief (seconds) spells of severe vertigo associated with change in head position, such as Rolling over in the bed, Getting into bed and assuming a supine position , Arising from a bending position ,Extending the neck , Turning rapidly
- A loss of balance or unsteadiness