April 25, 2026

@michaelokun

Why does the room spin when you roll over in bed? Have you heard of BPPV. Kristin Walter and colleagues describe in a new person w/ disease page in JAMA what benign paroxysmal positional vertigo is, why it happens and how we can treat it effectively. Key Points: - BPPV occurs when tiny calcium crystals in the inner ear become dislodged and move into the semicircular canals, triggering false signals of movement. - Episodes are brief, typically less than one minute, and are frequently triggered by head movements like lying down or turning in bed. - The Epley maneuver maneuver is highly effective, resolving symptoms in most folks, frequently after just one or a few treatments. My take: This is one of the most common and most treatable causes of dizziness we see. The key is recognizing it early and getting the right maneuver. Many folks suffer longer than needed because the diagnosis is missed or delayed. Don't forget about the recent randomized trial in JAMAN that showed Semont plus superior to Epley. https://jamanetwork.com/journals/jamaneurology/fullarticle/2806601 Here are 5 points that resonated w/ me from person w/ disease page: 1- BPPV is mechanical, not dangerous, and it comes from displaced crystals in the inner ear. 2- Simple bedside testing by health care providers can confirm the diagnosis quickly. 3- The Epley (or Semont-plus) maneuvers can fix the problem by moving crystals back where they belong. 4- Fall risk increases in untreated BPPV, especially in older adults, so early treatment matters. 5- If symptoms persist, referral to vestibular experts such as neurologists, otolaryngologists or physical therapists can make a big difference. https://cutt.ly/gtJ9DDZI #michaelokun #fixelinstitute #vertigo #dizziness