There are some rare conditions that have symptoms that resemble BPPV. Most other conditions that have positional dizziness get worse on standing rather than lying down(e.g., orthostatic hypotension). With respect to history, the key observation is that dizziness is triggered by lying down, or upon rolling over in bed. The severity of the personвЂ™s dizziness often correlates to the severity of these eye movements. This also looks like the rotation of a doorknob as the eye repetitively snaps back to its starting position. The eyes jump upward as well as twitch so that the top part of the eye jumps toward the down side. The physician will look carefully for these eye movements as the direction of these movements tells him what part of which ear is involved. A positive Dix-Hallpike test consists of a burst of nystagmus (jumping of the eyes). The Dix-Hallpike test is done when a person is brought from sitting to a lying down position, with the head turned 45 degrees to one side and extended about 20 degrees backward. Often, the diagnosis can be made with history and physical examination alone. HOW IS THE DIAGNOSIS OF BPPV MADE?ДЄ Physician can make the diagnosis based on history, findings on physical examination, and the results of vestibular and auditory tests. In half of these cases, BPPV is called вЂњidiopathic,вЂќ which means it occurs for no known reason.

While rarely encountered, BPPV is also common in persons who have been treated with medications which may be toxic to the ear, such as Gentamicin.

Occasionally BPPV follows surgery, including dental work where the cause is felt to be a combination of a prolonged period of supine positioning, or ear trauma when the surgery is to the inner ear. Viruses affecting the ear such as those causing vestibular neuritis and MeniereвЂ™s Disease are significant causes. BPPV becomes much more common with advancing age. In older people, the most common cause is degeneration of the vestibular system of the inner ear. There is also a strong association with migraines. The head injury doesnвЂ™t need to be that direct, even whiplash injuries have a substantial incidence of BPPV. The most common cause of BPPV in people under the age of 50 is a head injury. BPPV may be present for a few weeks, then stop, then come back again weeks or months later. An вЂњon-again, off-againвЂќ patter is also common. A Yoga posture called the вЂњdownward dog,вЂќ or Pilates are sometimes the trigger. Women with BPPV may find that the use of shampoo bowls in beauty parlors bring on symptoms. Because people with BPPV often feel dizzy and unsteady when they tip their heads back to loop up, sometimes BPPV is called вЂњtop shelf vertigoвЂќ. Getting out of bed or rolling over in bed are common вЂњproblemвЂќ motions. Activities which bring on symptoms will vary among persons, but symptoms are almost always precipitated by a change of position of the head with respect to gravity. The symptoms of BPPV include dizziness or vertigo, imbalance, and nausea. In one study, 9% of a group of active elderly people were found to have undiagnosed BPPV. About 50% of all dizziness in older people is due to BPPV. While BPPV can occur in children, the older you are, the more likely it is that your dizziness is due to BPPV. About 20% of all dizziness is due to BPPV. They are probably dissolved naturally as well as actively reabsorbed by the вЂњdark cellsвЂќ of the labyrinth, another portion of the complex inner ear, which is found adjacent to the utricle and the crista, although this idea is not final and accepted by all ear specialists.Д«PPV is a common cause of dizziness. Normally otoconia appear to have a slow turnover. The utricle or the cupula may have been damaged by head injury, infection, chemical changes, or other disorder of the inner ear, or may have degenerated because of advanced age. While the saccule also contains otoconia, they are not able to migrate into the canal system. Ear rocks are small crystals of calcium carbonate derived from a structure in the ear called the utricle and the cupula. This debris can be thought of as, вЂњear rocksвЂќ, although the formal name is, вЂњotoconiaвЂќ. In Benign Paroxysmal Positional Vertigo (BPPV), dizziness is generally thought to be due to debris which has collected within a part of the inner ear.

Ear crystals vertigo