BPPV

Benign paroxysmal positional vertigo (BPPV) is a mechanical vestibular disorder. Tiny calcium-carbonate particles called otoconia normally sit in the utricle, where they help detect linear acceleration and gravity. When particles become dislodged and enter a semicircular canal—most often the posterior canal—they move with changes in head position and disturb the canal’s fluid dynamics. The brain then receives a false signal of head rotation. That mechanism explains the characteristic pattern: turning in bed, lying back, looking upward, or bending forward provokes a sudden spinning sensation. The episode is brief, typically less than one minute, because the displaced particles settle. The patient may feel mildly unsteady afterward, but ongoing spontaneous vertigo is not the usual BPPV pattern. An experienced nurse listens for the timing before focusing on the word dizzy. “The room spins for 20 seconds whenever I roll to my right” supports BPPV. Constant vertigo, faintness without head movement, or new neurological symptoms requires a different level of concern.