What is BPPV and what factors lead up to having this diagnosis?

What is Benign paroxysmal positional vertigo (BPPV)?

Benign paroxysmal positional vertigo (BPPV) can be defined as transient, position-induced torsional, vertical, or horizontal nystagmus with vertigo.

Woah, lots of words! What does that mean to the non-medical person?!

It basically means someone with BPPV has vertigo that is provoked by specific head positions. Classically, these head positions are usually looking down or even rolling over in the bed.

The good thing —- this is a benign condition and can sometimes improve just on its own but even if you have to see a healthcare provider, most symptoms improve within 2-3 visits!

What causes BPPV?

The pathology is based on displacement of the cupula due to either free-floating debris/ otoliths in the semicircular canal (canalolithiasis) or attachment of debris/otoliths to the cupula (cupulolithiasis). It can be a primary issue or secondary issue from other conditions.

Unfortunately, the underlying pathology is often obscure and the “main” reason is not always known – hence, what we call idiopathic. In this case, we call it idiopathic BPPV.

What factors lead up to having this diagnosis?

Considering most cases of BPPV are idiopathic, there are other factors associated with BPPV. Everyone wants to know “why” they have this diagnosis and as healthcare professionals, we can’t always pinpoint one specific reason. But, usually there are several reasons that then “overload” your system and cause a “spill-over” effect —- which means your body can’t compensate any further and you get symptoms.

Here is a list of 18, yes 18, factors associated with BPPV!

  1. Aging

  2. Migraine

  3. Meniere’s Disease

  4. Trauma (such as car accident, concussion, whiplash)

  5. Infection

  6. Vestibular Neuronitis

  7. Idiopathic sudden sensorineural hearing loss

  8. Sleeping habits

  9. Osteoporosis and vitamin D insufficiency

  10. Hyperglycemia and diabetes mellitus

  11. Chronic head and neck pain

  12. Vestibule or semicircular canal pathology

  13. Pigmentation disorders

  14. Estrogen deficiency

  15. Neurological disorders

  16. Auto- immune, inflammatory, or rheumatologic disorders

  17. Familial or genetic predisposition

  18. Allergy

Wow, that’s a lot of factors that could lead to you having BPPV!

What does all of this mean for me if I have BPPV?

Basically, this means that the well-rounded treatment is more than just “a manuever”. We recommend someone who has the time and training to examine your symptoms but discuss lifestyle factors and other strategies to not only prevent it from having again but overall, address your entire body and give you answers.

If you want an in and out manuever, we can do that. We have the technology (see picture) to find out which canal your symptoms are coming from and overall provide the most detailed diagnosis.

Additionally, we also take the time to really discuss your health and these other factors that may affect your overall well-being that led to your body giving you vertigo in the first place!

If you are suffering from BPPV, contact us to see how we can help you!


Dr. Danielle Vaughan is a Vestibular Rehabilitation Specialist & Women’s Health Physical Therapist in Wake Forest, North Carolina. She co-owns PhysioFit of North Carolina. She provides specialized treatments for Dizzy and Vertigo conditions with 1 on 1 care for all her patients.

Call us: 919-728-0335