Is Benign Paroxysmal Positional Vertigo (BPPV) really Benign?

For those who have BPPV, the misnomer it is a benign disorder is real.  The sensation of vertigo can be frightful and cause severe panic.  You can fall and even end up in the ER due to nausea and persistent vomiting.  So why do they call it benign?  Moreover, what is happening that causes BPPV in the first place.  BPPV is a phenomenon where tiny particles of debris are floating in the fluid of your ear.  That is the benign component.  What is not benign is why.  The most common cause of BPPV is due to the degeneration of the macular bed.  So what is a macular bed?  It is the area in the ear where the hairs of the inner ear attached to sense motion.  You see, your inner ear has hairs in it that sense movement – kinda like whiskers on a cat.  The are very sensitive and are attached to a layer of crust that is the BPPV debris.  The layer of crust will break lose at times  – in most cases for no reason, but it can be due to disease or even just poor blood flow to the sensor.  Bottom line, when it comes off, it won’t grow back, and you are left with a partial macular bed, hairs, and sensor.  This can cause prolonged or residual dizziness including imbalance and lightheadeness leading to falls and reduced activity.  For a senior, it could end up being a hip fracture or even worse, death.  So to say BPPV is benign is completely wrong – don’t let them tell you this.  Make sure you are completely evaluated if you have BPPV beyond a simple maneuver on a table for treatment.  It may save your life.

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