Benign Paroxysmal Positional Vertigo (BPPV) is a common cause of dizziness that affects the Australian community. A description of the condition must be preceded by a brief overview of the anatomy of the inner ear that is involved in the manifestation of BPPV. One of the ways in which the brain receives information about where our bodies are in space is through the semicircular canal located deep within the skull. They consist of three canals at right angles to each other and filled with a fluid called endolymph. Located within walls of these canals are fine hair like structures called cilia with small calcium balls called catholiths on the tip. As inertia causes the endolymph to flow through the canals as we move about performing our daily activities, the catholiths ebb and flow through the fluid causing the cilia to stimulate nerves that are attached to their base. Our brain receives this nerve stimulation and along with our other senses, determines how we are moving.

BPPV occurs as a result of these catholiths breaking away from the cilia and causing stimulation of the nerves at the base of the cilia at inappropriate time. This is what we know as one type of dizziness called BPPV. The procedure that physiotherapists use to control this condition is called the Epley-Parnese maneuver. This involves moving the patient through a very slow and specific series of positions that drains these free catholiths to an area of the inner ear called the utricle, where they cannot cause any of this inappropriate stimulation.

This completed, the dizziness caused by BPPV, is resolved for the time being. It is possible for the catholiths to work their way out again in which case the maneuver is repeated.

The beauty of the procedure is that it simple to learn and has no risk associated with it. If correctly diagnosed, the patient can only improve.

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