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Benign Paroxysmal Positional Vertigo, also known as BPPV is one of the most common causes
of dizziness. There are two types a balance organs in the inner ear; the semicircular
canals and the otolith organs. The otolith organs contain crystals of calcium carbonate
which are constantly being shed, dissolved and replaced by new ones. If too many crystals
fall off at one time and the patient looks up or lies down before they dissolve, they
can fall into one of the semicircular canals. When the patient rises, they don't fall out,
they fall in and become trapped in the canal. Upon lying down the crystals fall through
the canal, causing an intense spinning that lasts a few seconds until the crystals fall
to the lowest point. When rising, the crystals fall in the other direction which again triggers
dizziness. Until the crystals are dissolved, the canal may not work properly and chronic
disequilibrium as well as positional vertigo may be present. This will continue until the
crystals in the canal dissolve or are moved out of the canal with special exercises or
maneuvers. Even untreated, most cases of BPPV resolve within 14 days.