What is BPPV? |सिर चकराना): प्रमुख जानकारी Dr. Major Rajesh Bhardwaj

Vertigo Caused by Bppv? There Could Be Many Types

BPPV - Benign Paroxysmal Positional Vertigo is the commonest cause of Acute Peripheral Vertigo (giddiness, 'chakkar').

It is generally considered that this is one disease but this is not true.
There are many variants of BPPV and as we understand more about this disease we realize that many different parts of the inner ear may be involved.

BPPV is caused by the accumulation of particles (Otoliths) in the Semicircular canals - these are calcium crystals that get deposited in the vestibular balance organs and their movement caused by neck movement leads to giddiness. The Otoliths sometimes arise in the Cupula as well.
The giddiness associated with BPPV is sudden and very short-lasting - a few seconds - but this may be followed by some unsteadiness for some time. There may be associated nausea and vomiting.
It is usually seen in older individuals and sometimes there may be a previous history of head trauma.

Though the giddiness has no relationship with cervical spondylosis, the association with neck movement sometimes leads patients and clinicians to feel that the episode is because of Cervical Spondylosis. That is not true.

To understand the different variants of BPPV, we need to look at the anatomy of the Inner Ear.
The Inner Ear performs two most important functions in the human body- Hearing and Balance.
The part of the inner ear that is responsible for hearing is the Cochlea and the part responsible for balance is the Vestibule.
The vestibular system consists of the vestibule the semicircular canals, and the structures of the membranous labyrinth inside.

The constituents of the Vestibular system then are the Utricle, the Saccule, and the three semicircular canals. The semicircular canals are oriented in different directions and are responsible for maintaining balance in their respective axes.

Types of BPPV
The most useful BPPV classification for clinical practice is based on which canal is involved.
• Posterior semicircular canal (PSC)
• Lateral semicircular canal (LSC)
• Anterior semicircular canal (ASC)
• Multicanalar BPPV
– Simultaneous involvement: Posttraumatic BPPV
– No simultaneous involvement: Canalar conversion
The implication of this is that no single test or manoeuvre is sufficient to diagnose or treat the disease.

BPPV arising from the Posterior Semicircular Canal is the most common lesion, accounting for nearly 80 % of the cases.
To understand which canal could be causing the giddiness in the patient a series of tests are carried out to come to a diagnosis.
Once we know that an appropriate maneuver is done to correct the condition.

This Video and the accompanying information is not a substitute for a medical consultation.
Kindly consult your Doctor for your medical queries.

Vertigo, BPPV, Giddiness, Chakkar
We have a dedicated Vertigo Clinic for the management of patients of

1. Vertigo
2. Imbalance
3. Unsteadiness
4. Frequent Falls

Detailed tests are carried out - VOR, VNG, and Caloric Test to reach a diagnosis
Particle Repositioning manoeuvres are done when required - like Epley's manoeuvre.
Vestibular Rehab Exercises and medication are sometimes prescribed.

About The Doctor!
Our center is run by Dr. (Major) Rajesh Bhardwaj, who brings over 15 years of Army service into his civilian practice, ensuring that every patient is treated with discipline, care, and precision. He has an MBBS from AFMC in addition to an MS, DNB, DLO, and DHA, making him one of the most qualified and experienced ENT specialists in the region.

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Dr. Bhardwaj’s decades of experience ensure that the information provided is medically accurate, comprehensive, and easy to understand. However, this content is intended for educational purposes and should not be considered a substitute for professional medical advice. Always consult a qualified healthcare provider for any medical concerns.