Changes in head position – usually turning heads on the pillow before getting up early morning, or look up to reach high shelves often trigger episodes of this mess. BPPV usually develops when particles of calcium that is usually bonded to one part of the inner ear (utricle and saccule) displaced and moved to other parts of the inner ear (posterior semicircular canal). The inner ear consists of three semicircular canals, which help balance. Posterior canal, unlike the anterior and horizontal canals, is the best place to receive almost all of the release of particles by gravity through the night. When they get together, they form a chalky dirt and may further establish the exaggerate the movement of fluid in the canal when the head changes position.

Produce excessive stimulation of nerve receptors (hair cells) in the posterior canal to make the brain feel as if the head is moving more quickly and more than usual. This information does not match the eye and the joint position sensors. This imbalance produces a brief episode of vertigo. Particles may be separated from the utricle and saccule with increasing umurg. Alternatively, the release of wound infection may be caused by ear, extending rest periods in bed, ear surgery, head injury, or choked in the inner ear artery.

This type of vertigo can be scary, but usually harmless and go away. Possibly accompanied by nausea, vomiting, and nystagmus specific (rapid eye movement widened in one direction alternate with slower movements decreased to the original position). Episodes of vertigo started after 5 to 10 seconds after the head and survived less than a minute. Episodes usually subside on its own within a few weeks. Occasionally, they persist for many months and can lead to dehydration due to nausea and vomiting. No hearing loss or ringing in the ears (tinnitus).

Diagnosis
Diagnosis based on description of symptoms and the situations in which they occur. Dix Hallpike action stimulates the posterior canal. People sat on the examination table with the head directed 45 degrees to the right. Then the man lying on your back so keep your head in the direction 45 degrees and depending on the examining table about 20 degrees. In BPPV, there is a delay of about 5 to 10 seconds before vertigo and nystagmus blocked, but it may be a long delay for 30 seconds. Symptoms last 10 to 30 seconds. Visual fixation can shorten or even eliminate the nystagmus, and therefore the action should ideally be done by dressing with Frenzel lenses (which makes it impossible to visually berfiksasi on anything). When the action is repeated several times, the intensity of vertigo and nystagmus decreases (habituation). Different circumstances, a position associated with central vertigo causes symptoms immediately. Vertigo continues for the head in the same position, and no habituation to repeat the action. Dix Hallpike action so can assist clinicians in differentiating the causes associated with the normal ear, such as BPPV, from an important cause more serious, such as stroke and multiple sclerosis.

TREATMENT
BPPV be easily treated. Simply need to be removed particles from the posterior semicircular canal and return it to where they came from. This requires a maneuver such as overturning the head in space. These maneuvers are called canalith repositioning actions or Epley maneuver, after the doctor who pioneered. This maneuver immediately cure vertigo about 90% of patients. Repeating the maneuver increases of 5% again. In some people, recurrent vertigo. If done, the maneuver again. People can be taught how to maneuver at home if recurrent vertigo. To 5% of people who are not cured with the maneuver, the medicine may be used. Very rarely, surgery is needed. Sometimes, the horizontal canal is affected, and rolled a log itself can reduce the symptoms.