Vertigo, Benign Paroxysmal Positional (BPPV)
- Benign paroxysmal positional vertigo (BPPV) is a mechanical disorder of the inner ear characterized by a brief period of vertigo experienced when the position of the patient’s head is changed relative to gravity.
- Vertigo results from the mismatch of the perception of movement by the visual, vestibular, and proprioceptive symptoms when none exist.
- The brief period of vertigo is caused by abnormal stimulation of ≥1 of the 3 semicircular canals of the inner ear, with the posterior canal most commonly affected.
- BPPV is the single most common cause of vertigo.
- Lifetime prevalence is 2.4%, and 1-year incidence is 0.6%.
- Age of onset is most commonly between the 5th and 7th decades of life.
- Incidence increases with each decade of life.
- Prevalent sex: female > male
- BPPV affects the quality of life of elderly patients and is associated with reduced activities of daily living scores, falls, and depression.
1-year incidence 0.6%
Lifetime prevalence 2.4%
Etiology and Pathophysiology
- In BPPV, calcite particles (otoconia) that normally weigh the sensory membrane of the maculae become dislodged and settle into the semicircular canal, changing the dynamics of the canal. Reorientation of the canal relative to gravity causes the otoconia to move to the lowest part of the canal, causing displacement of the endolymph, deflection of the cupula, and activation of the primary afferent. This results in the generation of nystagmus and the associated sensation of vertigo.
- BPPV may be idiopathic, posttraumatic, or associated with viral neurolabyrinthitis.
There's more to see -- the rest of this topic is available only to subscribers.
Domino, Frank J., et al., editors. "Vertigo, Benign Paroxysmal Positional (BPPV)." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2020. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816703/all/Vertigo__Benign_Paroxysmal_Positional__BPPV_.
Vertigo, Benign Paroxysmal Positional (BPPV). In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2020. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816703/all/Vertigo__Benign_Paroxysmal_Positional__BPPV_. Accessed June 8, 2023.
Vertigo, Benign Paroxysmal Positional (BPPV). (2020). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (27th ed.). Wolters Kluwer. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816703/all/Vertigo__Benign_Paroxysmal_Positional__BPPV_
Vertigo, Benign Paroxysmal Positional (BPPV) [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2020. [cited 2023 June 08]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816703/all/Vertigo__Benign_Paroxysmal_Positional__BPPV_.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Vertigo, Benign Paroxysmal Positional (BPPV) ID - 816703 ED - Domino,Frank J, ED - Baldor,Robert A, ED - Golding,Jeremy, ED - Stephens,Mark B, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816703/all/Vertigo__Benign_Paroxysmal_Positional__BPPV_ PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -