BPPV Basics and Symptoms
BPPV, or benign paroxysmal positional vertigo, is a common inner ear condition caused by tiny calcium crystals called otoconia that drift into the semicircular canals. When these crystals move with head changes, they trigger brief spinning vertigo and associated dizziness. In Korean, this condition is often referred to as 이석증.
Most people experience brief vertigo lasting seconds to a minute, triggered by lying down, turning over, or tilting the head. Nausea and lightheadedness may accompany the dizziness, but the symptoms usually resolve with a quick change in position. While disorienting, BPPV is not life threatening and often responds well to targeted therapies.
Diagnosis and Tests
The Dix-Hallpike test is the standard diagnostic maneuver for BPPV. During the test, the clinician positions you quickly and observes eye movements for nystagmus. A positive result, along with your vertigo symptoms, helps confirm the diagnosis.
Additional vestibular assessments such as videonystagmography or ENG help map eye movements and confirm the diagnosis. They can quantify the eye response to position changes and distinguish peripheral from central causes. Imaging like MRI is reserved for atypical cases or when red flags appear, such as persistent imbalance, headache, or neurological signs.
Recovery and Aftercare
Treatment involves maneuvers like the Epley or Semont to move the displaced crystals back to their proper position. These procedures are typically performed by trained clinicians and have high success rates. After a session, many patients notice relief and a reduced frequency of vertigo episodes.
Maintenance includes simple home exercises, staying hydrated, and avoiding sudden head motions for a day or two after treatment. Some clinicians recommend vitamin D optimization, as low levels may be linked to higher recurrence, though evidence varies. Regular follow-up ensures the maneuvers remain effective and adjustments can be made if vertigo returns.