Benign paroxysmal positional vertigo (BPPV) is a common syndrome characterized by short-lived episodes of vertigo triggered by specific head movements. It is caused by an imbalance in the functioning of the balance organ and can be categorized as canalolithiasis or cupololithiasis, depending on the displacement site of the otoliths, also reffered to as ear crystals. Patients with BPPV often experience symptoms while sleeping, turning over in bed, looking up, or bending their head. Despite the unsettling nature of the symptoms, BPPV is generally considered a non-serious condition, as it can be effectively treated in most cases.

Also known as earstones, ear cystals can be found within the inner ear. The inner ear consists of two main organs: the cochlea, which is responsible for hearing sounds, and the labyrinth, which is responsible for both hearing and equilibrium. The labyrinth is composed of three semicircular canals that detect rotational acceleration of the head and two organs called the utricle and saccule, which help perceive gravity.

The utricle and saccule contain otoliths, which are ear crystals suspended in a fluid within the inner ear. These ear crystals are capable of sensing movement and stimulate receptor cells to send signals to the brain, informing it about changes in the head's position in space. This communication between the otoliths and receptor cells is essential for our sense of balance and spatial orientation.

The displacement of ear crystals can lead to dizziness and a sensation of being on a spinning carousel. Normally, the otoliths should be in their proper position, but when they move towards the semicircular canals, they stimulate receptors associated with head acceleration, creating a false perception of the surroundings rotating. Various factors can cause ear crystals to dislodge, including ear infections, head trauma, sudden and excessive head movements, and high levels of stress.

Identifying the cause of otolith displacement in cases of head trauma is crucial as it helps in understanding the underlying mechanism and guiding appropriate treatment strategies. Idiopathic paroxysmal positional vertigo (IPPV) is a diagnosis given when the underlying cause of otolith displacement cannot be identified.

Si raccomanda vivamente ai pazienti di rivolgersi a un otorinolaringoiatra esperto per riallineare il cristallo nell'orecchio. Per risolvere tempestivamente il problema e ridurre al minimo i sintomi e il disagio associati, gli specialisti possono eseguire la manovra di riposizionamento degli otoliti, nota anche come manovre di Epley o procedura di riposizionamento dei canaliti, che prevede specifici movimenti della testa per riposizionare i cristalli spostati . 

When you turn over in bed, the movement of the head can cause these displaced crystals to move within the semicircular canals, sending confusing signals to the brain about your body's position. This disruption in the normal balance system can lead to feelings of dizziness or a spinning sensation.

If you are experiencing the onset of dizziness, particularly when triggered by specific head movements (such as upward, downward, or horizontal motions), it is crucial to promptly contact a hearing specialist for a proper diagnosis and appropriate treatment.

Treatment for positional vertigo typically involves specific maneuvers, such as the Epley maneuver or the Semont maneuver, which aim to reposition the dislodged crystals back to their correct location within the inner ear. These maneuvers can effectively alleviate symptoms. 

However, it is important that these maneuvers are conducted exclusively by trained professionals.