Paroxysmal positioning vertigo (PPV) is a major cause of vertigo accounting for 14 % of all equilibrium disorders with an annual incidence of about 100 per 100,000 of population . It starts suddenly and is usually first noticed in bed, when waking from sleep. Any turn of the head seems to bring on violent but brief bursts of dizziness. Patients often describe the occurrence of vertigo with tilting of the head, looking up or down, or rolling over in bed. It is not unusual for nausea and vomiting to accompany the vertigo. Even if a spell is brief, a feeling of queasiness may last several minutes or even hours, and those who suffer from this kind of vertigo are distressed and incapacitated for several days severely impacting on social costs due to lost working days. PPV is a common vestibular disorder leading to significant morbidity, psychosocial impact, and medical costs. PPV accounted for 8 % of individuals with moderate or severe dizziness/vertigo. Is commonly accepted that PPV is due to displacement of otoconia and/or to vestibular macula/maculae lesion.
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