Understand BPPV in One Minute – Michael Teixido, M.D. Benign Paroxysmal Positional Vertigo, also known as BPPV is one of the most common causes of dizziness. There are two types a balance organs in the inner ear; the semicircular canals and the otolith organs. The otolith organs contain crystals of calcium carbonate which are constantly being shed, dissolved and replaced by new ones. If too many crystals fall off at one time and the patient looks up or lies down before they dissolve, they can fall into one of the semicircular canals. When the patient rises, they don't fall out, they fall in and become trapped in the canal. Upon lying down the crystals fall through the canal, causing an intense spinning that lasts a few seconds until the crystals fall to the lowest point. When rising, the crystals fall in the other direction which again triggers dizziness. Until the crystals are dissolved, the canal may not work properly and chronic disequilibrium as well as positional vertigo may be present. This will continue until the crystals in the canal dissolve or are moved out of the canal with special exercises or maneuvers. Even untreated, most cases of BPPV resolve within 14 days.