This week I spent 2 days in the hospital due to BPPV. I had a pronounced bilateral presentation. I feel good now via Epley, Hall Pike, supine roll. For years I have been very sensitive to carnival rides, exiting a dentist chair, getting up too fast following sit-ups. I wrote this all off as “normal.” Is it possible that I have had these out of place crystals for months/years and have just now reached a threshold triggering the “attack?”
In order to have a severe attack of BPPV, you need a large mass of crystals that have joined together to form one or more chunks. The overall mass of the chunks determines the severity of the attacks. Probably most people have a few crystals in the canals as they age, but unless a clump forms they may never have a problem.
The crystals have a sticky coat and can drag along pieces of the very sticky membrane that they attach to in the utricle (gravity sensor of the ear). This makes it easy for clumps to form. Lying in one position for a long time (like when you are in bed with the flu) can make this more likely to happen. Once a clump forms, it can exist for a long time. Even when it is rotated out of the canal with maneuvers, it may hang around waiting for another chance to fall back in.
Once a few crystals in small chunks start to accumulate in your ear canal, you might have very mild dizziness when arising or lying down quickly, not enough to see the room spin. If you pay attention, there may be a very short feeling of spinning—just a split second, a feeling of a quarter of a turn inside the head. However, over time these barely noticeable clumps can enlarge to the point that they suddenly cause a severe attack lasting as long as 30 seconds. It’s a good idea to try a maneuver or two if you have this milder dizziness, as this can clear out the canal and prevent the small clumps from joining to form a larger one.
Since you were in the hospital, the attack must have been very severe. This always raises the possibility of other vertigo problems that are not as easily treated as BPPV. It’s a good idea to have a hearing test and balance test if this severe dizziness recurs.