Vertigo is one explanation for why people feel dizzy. It is a false sense of rotation and is often described as a room spinning sensation despite being stationary. It can be caused by many different diseases including certain strokes, migraines, inflammation involving nerves of the ear and an entity known as benign paroxysmal positional vertigo (BPPV) which is what this discussion will focus on. Benign paroxysmal positional vertigo is the most common type of vertigo with a lifetime prevalence of 2.4%. Although BPPV can happen to anyone of any age, the most typical age range is 50-60 years old and is more common is about twice as common in women compared to men. The cause of the disease is formation of small stones that develop in a structure within the inner ear that contributes to balance, the semi-circular canals. The most common symptom patients complain of is a room spinning sensation when they turn their head quickly such as rolling over in bed. The diagnosis depends on a thorough history and physical exam including some special techniques and maneuvers. In some cases, diagnostic studies may be required to rule out other more serious causes of vertigo such as stroke. Benign Paroxysmal Positional Vertigo can be improved with exercises to move the stones from the semicircular canals. Often times these non-invasive maneuvers are performed by a physical therapist with advanced training in the exercises. Sometimes, patients require medications for symptom relief until the physical therapy techniques begin to work.
Kim JS and Zee DS. Clinical Practice: Benign Paroxysmal Positional Vertigo. N Engl J Med. 2014. Mar 20; 370: 1138-1147.