Which statement about BPPV is TRUE?

• A. Vertigo lasting all day without head movement
• B. It is a central vestibular disorder
• C. It commonly affects only hearing, not vertigo
• D. Vertigo episodes are brief and triggered by changes in head position

Answer: (D)

Positional, brief vertigo is the hallmark of BPPV. It happens when head movements change the orientation of gravity in the inner ear, causing small crystals (otoconia) to drift into a semicircular canal, most often the posterior canal. As you move your head, these crystals shift within the canal and briefly stimulate hair cells, producing a spinning sensation that lasts seconds to a minute and often with a brief nystagmus. This pattern—short episodes triggered by specific head positions such as tipping the head back, rolling over in bed, or getting out of bed—is what distinguishes BPPV from vertigo that lasts all day or isn’t linked to head movements.

BPPV is a peripheral vestibular disorder, not a central one, and hearing is usually not affected, so vertigo remains the primary symptom rather than hearing loss. The combination of brief, position-triggered episodes is the best reflection of the condition’s typical presentation.