This type of vertigo mainly affects women and the elderly

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Among the peripheral vestibular disorders, benign paroxysmal positional vertigo (BPPV) is the most common. Benign paroxysmal positional vertigo is characterized by episodes of vertigo roundabout when the head is moved.

BPPV is more common in women and seniors over 60 years old. Sorry ladies!

Benign paroxysmal positional vertigo can happen through two different mechanisms:

Canalithiasis

  • degenerative debris (otoconia fragments) of the utricle are circulating freely in the endolymph of the semicircular canals of the labyrinth

Cupulolithiasis

  • these same degenerative debris are not circulating in the canals but adhered to the cupula of the posterior canal, making it more sensitive to gravity

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The diagnosis of BPPV is clinical and is done mainly through maneuvers that determine what canal and what type of BPPV patients present. Treatment success depends on identifying and specifying the type of BPPV and canal involved. An accurate diagnosis and choice of appropriate maneuver are crucial to the success of the treatment. We consider it an important treatment option as it is an effective, reliable and non-invasive therapeutic approach.

Some people have tried different maneuvers and tests on themselves that they have found online. In some instances, this can be okay; but in others, you could potentially float the otoconia fragments from canal to another, which can then give you different symptoms. This of course, is not as successful as a true canalith repositioning procedure performed by a vestibular specialist.

This treatment is effective in resolving symptoms, both in short and long term. There are some individuals who need some follow-up sessions over time for just canalith repositioning or the procedures plus vestibular rehabilitation. Talk with your therapist to determine best approach to help you the most.

If you are experiencing dizziness, vertigo, unsteadiness or lightheadiness, contact us to make an evaluation so we can find out the cause and perform procedures to help you!


Dr. Danielle Vaughan is a Physical Therapist who specializes in Vestibular Therapy. She is co-owner of PhysioFit of North Carolina. Not only does Dr. Vaughan address the vestibular system, but she can evaluate and treat the musculoskeletal system. Therefore, if you are also having neck, shoulder or back pain associated with your dizziness, you will have a specialist in both areas working on you!