Benign Paroxysmal Positional Vertigo (BPPV) is an abnormal sensation of spinning triggered by changes in head or body position with respect to gravity. This is caused by a disorder in the inner ear, specifically in the semicircular canals, which function as one of the body's balance organs.

BPPV is one of the most common types of vertigo seen in clinics, and the symptoms include a spinning sensation, especially when there is a sudden change in head position, such as when getting out of bed, kneeling, exercising, dancing, and others. The spinning sensation can also be accompanied by other symptoms such as nausea, vomiting, cold sweats, and nystagmus (repetitive and uncontrollable eye movements).

About 50% of BPPV cases have an unknown cause, but it is suspected that head trauma (17%) followed by vestibular neuritis (15%), migraines, dental implantation, and ear surgery can also be a result of prolonged bed rest or post-operative positioning.

The pathophysiology of this disease occurs in the inner ear. The inner ear contains an organ with three circular canals called the Semicircular Canals that contain fluid and sensory hairs responsible for recognizing head position and movement. The inner ear also contains an Otolith organ that contains crystals that are sensitive to head movement and changes in position called Otoconia. These crystals can detach due to various causes and eventually enter the semicircular canals. The crystals that enter the semicircular canals stimulate the sensory hairs and send a signal to the brain that there is a false change in position. This false change in position signal causes the patient to experience an abnormal spinning sensation.

BPPV must be distinguished from other types of vertigo because the causes and pathophysiology are different. This can be determined through several tests such as Electronystagmography, MRI, blood pressure examination, external ear examination, Audiometry, and physical examination by an ENT doctor.

If you experience a spinning sensation, it is advisable to consult a doctor immediately and undergo an examination to determine the diagnosis of the disorder. The treatment for BPPV involves removing Otoconia crystals from the semicircular canals with specific maneuvers performed by an ENT specialist.

Author: Dr. Apri Kristanto Utomo (Medical Laboratory Services Doctor at PRAMITA Clinic Branch Jl. Adityawarman No. 73-75 Surabaya)

REFERENCES

2014, Diagnosis and Management of Benign Paroxysmal Positional Vertigo (BPPV) Horizontal Based on Head Roll Test, Yan Edward, Yelvita Roza, THT-KL Department Faculty of Medicine, Andalas University,

https://vestibular.org/article/diagnosis-treatment/types-of-vestibular-disorders/benign-paroxysmal-positional-vertigo-bppv

https://www.nationaldizzyandbalancecenter.com/how-to-diagnose-vertigo

https://nyulangone.org/conditions/vertigo/diagnosis