BPPV: A Common Cause of Dizziness

One day my dad came to me with a concern regarding his balance. He stated that anytime he looks up, bends over or rolls over to his right side, he gets really dizzy. I knew immediately what was going on and was happy to be able to help him.

He was suffering from Benign Proximal Positional Vertigo, or BPPV, which is one of the most common causes of dizziness. BPPV causes short (less than a minute) episodes of spinning. People often notice it in the morning when getting out of bed or if they tilt their head back to look at something above them. BPPV occurs when tiny calcium carbonate crystals interfere with our vestibular ocular reflex.

I like to think of our vestibular ocular reflex as a tripod and our vision as a video camera. When the reflex is working properly, everything is stable and easy to see. When the reflex is not working, things are jittery, hard to watch and often make us sick. Our brain uses our eyes, ears and nerve endings in our ankles, knees and hips to keep us upright and stable. Our ears collect information about how we are moving, which is directed to our eyes through the vestibular ocular reflex. The eyes then move equal and opposite the perceived movement. This extremely fast response to movement keeps everything from bouncing around as we move.

BPPV deceives the brain into thinking you are still physically moving when you aren’t. So your eyes respond to a perceived movement that doesn’t exist. This causes you to get really dizzy. Fortunately, BPPV is easy to identify and treat. Studies suggest half of the population will suffer from it sometime in life. It occurs commonly after inner ear infections or trauma to the head. It also has been seen in individuals who have been bed ridden or have spent several hours working above their head.

Dad did give me a suspicious look after treatment, suggesting he did not believe we had done anything, which is not uncommon with my patients. That suspicion turned to gratitude when he woke up feeling better without dizziness the next morning, which is also not uncommon with my patients.

By Dr. Matthew Rumsey

Audiologist at Avera Sacred Heart

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