A few weeks, Mrs. J.M visited KUTRRH audiology clinic with acute onset dizziness (ceiling and things moving round) whenever she woke up from the bed or turned her head to the left. She reported that prior to that she had a severe cold which had been treated and recovered. She also experienced nausea and mild headache whenever dizziness occurred.The symptoms made her very worried because she didn’t know the cause and was worried of falling. Her vitals were normal. A full clinical vestibular assessment was done which revealed moderate left posterior canalithiasis benign paroxysmal positional vertigo (BPPV). A left Epley’s maneuver was done during the visit and was booked for review after a week. During the review she reported that the dizziness and associated symptoms had disappeared. Her anxiety had gone away and was back to her normal routine

What is BPPV?

BPPV is an inner ear disorder that causes a spinning sensation in a person whenever there is head movement. In most cases, BPPV is not a sign of serious disease. At most times the
spinning sensation disappears without intervention by around six weeks. It’s the most common condition of the ear that causes dizziness and simple spatial movement such as turning in bed, tipping your head backward or bending lead to a sudden vertigo. The vertigo is a feeling that the room and objects are spinning. The condition can be spelt out as :

• Benign: not life threatening
• Paroxysmal: come on suddenly
• Positional: only present when there is
head movement
• Vertigo: the sense of the environment
moving/ spinning

BPPV symptoms can be very frightening and lead to anxiety. The condition may be dangerous especially to older patients as the unsteadiness can lead to a fall causing trauma and sometimes fractures. The symptoms are mostly short term, lasting from a few days to weeks.

How common is BPPV

BPPV affects people of all ages but is rampant in adults over the age of 50 years. More than 20% of people evaluated for dizziness suffer from BPPV. In most instances, BPPV is self-limiting and can be successfully treated. Recurrence may happen after treatment, though it may take many months or years to come back and is often associated with some trigger.


Vertigo (spinning sensation) is the main symptom of BBPV. It normally lasts a few seconds up to a minute and may range from mild to severe sensation. Other accompanying features include:

• Nausea and vomiting
• Blurred vision
• Nystagmus (rapid involuntary eye
• Lightheadedness


Head movement is the main trigger of BPPV. Most people experience the vertigo when they tilt their head, when lying down, turning, or sitting up in bed.

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