Exploring the Link Between Traumatic Brain Injury and Benign Paroxysmal Positional Vertigo.

Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vestibular disorder, characterized by brief episodes of vertigo triggered by changes in head position. While idiopathic cases are frequent, post-traumatic BPPV has been increasingly recognized, particularly in individuals who have experienced traumatic brain injury (TBI). TBI, ranging from mild concussions to severe head trauma, is a significant cause of neurological morbidity and is often associated with vestibular dysfunction. The pathophysiology of post-traumatic BPPV is thought to involve direct mechanical disruption of the otolithic organs, alterations in endolymph dynamics, or vascular compromise affecting inner ear structures. Compared to idiopathic BPPV, post-traumatic cases tend to have a more prolonged and refractory course, often requiring multiple repositioning maneuvers for symptom resolution. Additionally, concurrent vestibular pathologies, such as vestibular migraine, post-concussive dizziness, or central vestibular dysfunction, may complicate diagnosis and treatment. Early identification and appropriate management of post-traumatic BPPV are crucial in reducing disability and improving the quality of life in affected patients. This review explores the epidemiology, pathophysiology, clinical characteristics, and treatment considerations of post-traumatic BPPV, emphasizing the importance of a multidisciplinary approach. Understanding the relationship between TBI and BPPV can enhance clinical decision-making and optimize rehabilitation strategies for individuals with vestibular dysfunction following head trauma.