BENIGN PAROXYSMAL POSITIONAL VERTIGO: A REVIEW OF MECHANISMS, DIAGNOSIS, AND INTERVENTIONS

Abstract

Benign Paroxysmal Positional Vertigo (BPPV) is the most common cause of peripheral vertigo, marked by brief, recurrent episodes of dizziness triggered by specific head movements. This condition arises from the abnormal displacement of otoliths in the inner ear, destabilizing the vestibular system. Diagnosis is confirmed through clinical maneuvers such as the Dix-Hallpike test, and canalith repositioning maneuvers, particularly Epley’s maneuver, are the most effective treatments. In recent years, research has highlighted new factors influencing the development and recurrence of BPPV. Studies indicate that metabolic conditions like vitamin D deficiency and osteoporosis increase susceptibility, especially among vulnerable populations such as the elderly. Additionally, evidence suggests that BPPV recurrence is linked to genetic factors, lifestyle habits, and even seasonal variations. Therapeutic advancements have emerged for refractory cases, including horizontal canal manipulation and vestibular rehabilitation, both of which enhance patients' quality of life. However, many aspects of BPPV’s underlying mechanisms remain under debate, particularly concerning hormonal influences and genetic predispositions that contribute to recurrences. Finally, understanding the physiological, metabolic, and genetic mechanisms that predispose individuals to BPPV is crucial for optimizing its management, minimizing recurrences, and ultimately reducing complications, particularly in high-risk populations like the elderly.