Benign Paroxysmal Positional Vertigo (BPPV)

Introduction

Benign Paroxysmal Positional Vertigo (BPPV) is one of the most common causes of vertigo, especially in adults and the elderly. It is characterized by brief episodes of dizziness triggered by changes in head position. Although not life-threatening, BPPV can remarkablyaffect balance, mobility, and quality of life. Early diagnosis and acquiring physiotherapy management play a vital role in rapid recovery.

Definition

Benign Paroxysmal Positional Vertigo is a vestibular disorder caused by the displacement of otoconia (calcium carbonate crystals) from the utricle into the semicircular canals of the inner ear, leading to abnormal stimulation during head movements.

Etiology:

• Displacement of otoconia (calcium carbonate crystals) from the utricle into the semicircular canals
  
• Age-related degeneration of the otolithic membrane
  
• Head trauma or minor head injury
  
• Inner ear disorders, such as vestibular neuritis
  
• Prolonged bed rest or immobilization
  
• Post-surgical changes, especially after ear or dental procedures
  
• Reduced blood supply to the inner ear
  
• Osteoporosis and vitamin D deficiency 

Clinical Features

• Sudden onset of vertigo lasting seconds to minutes
• Vertigo triggered by head movements such as rolling in bed or looking up
• Symptoms are often more prominent in the morning
• Recurrent episodes with symptom-free intervals
• No hearing loss in most cases

Signs and Symptoms

• Nausea and vomiting
• Imbalance 
• Nystagmus (involuntary eye movements)
• Dizziness when changing position
• Fear of movement due to symptom provocation
• Increased risk of falls, especially in older adults

Physiotherapy Management

Physiotherapy is the primary and most effective treatment for Benign Paroxysmal Positional Vertigo. Management includes:

• Vestibular Rehabilitation Exercises to improve balance and gaze stability
• Postural Training to Reduce Fall Risk
• Habituation Exercises for motion sensitivity
• Patient Education on safe movements and activity modification
• Home Exercise Programs to Prevent Recurrence
• Balance and Gait Training in the elderly or recurrent cases

Physiotherapy often provides rapid symptom relief, sometimes within one or two sessions.

complications

• Recurrent episodes of vertigo
  
• Increased risk of falls and related injuries
  
• Balance impairment and gait instability
  
• Anxiety and fear of movement
  
• Reduced ability to perform daily activities
  
• Motion sensitivity and dizziness with head movements
  
• Sleep disturbances from positional dizziness
  
• Reduced quality of life due to persistent symptoms

Conclusion

Benign Paroxysmal Positional Vertigo is a common yet highly treatable vestibular disorder. Accurate assessment and targeted physiotherapy interventions can effectively resolve symptoms, restore balance, and decrease recurrence. A timely and structured rehabilitation approach remarkably improves functional independence and quality of life.