Benign Paroxysmal Positional Vertigo (BPPV)

Benign paroxysmal positional vertigo (BPPV), the most common cause of peripheral vertigo, is attributed to canalithiasis, the presence of displaced calcium carbonate crystals (canaliths) within the semicircular canals of the inner ear.  BPPV typically presents as sudden, brief episodes of intense vertigo triggered by changes in head position.

Peripheral vertigo originates from dysfunction of the vestibular system within the inner ear.  The most common cause is BPPV, which occurs when canaliths, normally located in the utricle, become dislodged and migrate into the semicircular canals.  These canals are filled with endolymph and play a key role in detecting angular head movements.  Free-floating canaliths within the canal temporarily disrupt the normal flow of endolymph during head motion.  This results in abnormal activation of vestibular hair cells, sending false or conflicting signals of motion to the brain.  The mismatch between actual and perceived movement leads to the brief, position-triggered episodes of vertigo characteristic of BPPV.