BPPV stands for ‘benign paroxysmal positional vertigo’ and literally means dizziness when changing position, and without any sinister underlying cause. So, ‘benign’ means harmless, ‘paroxysmal’ means it’s sudden and brief, and ‘positional’ because the vertigo (the feeling like you’ve just gotten off a fairground ride) is triggered by changes in your head position. The inner ear is a series of tubes that give us our sense of balance, as well as hearing, and in BPPV, tiny crystals collect in the tubes, disrupting this. It’s the most common cause of vertigo, the sensation of the room spinning around you. This gives brief episodes of dizziness lasting less than a minute, and usually triggered by certain head movements. BPPV can also cause a loss of balance and nausea or vomiting. BPPV is more common the older you get, and in most cases occurs as a result of age-related degeneration of the ear system. About a third of the population will have experienced BPPV by the time they’re 70, with the peak age being in the 50s and 60s. It’s rare in children and young adults. There’s no specific cure for BPPV, but it’s not usually a sign of anything serious, and will usually get better on its own after several weeks, although it can come and go.

The inner ear contains a system of loopy tubes and sacs called the labyrinth, as well as two vestibular nerves that send information to your brain. These all help control your balance and hearing. Inflammation of this area creates a condition called labyrinthitis, and is commonly caused by a viral infection. Symptoms include dizziness, nausea and vomiting, sudden hearing loss, ringing in the ears (tinnitus), blurry vision, and feeling light-headed. You may experience vertigo, where it feels like you are in constant motion or the room is spinning. It feels a bit like you're on a boat in stormy seas.

Meniere's disease is a long-term condition of the inner ear that affects hearing and balance, and requires a trio of symptoms to make the diagnosis. About 1 in 1,000 people are affected by it, and it most commonly occurs between the ages of 40 and 60, although it can occur at any age. One ear only is usually affected initially, but about 40% of cases go on to affect both ears. It is named after the French doctor who first described it in the 1860s. The first symptom is vertigo, where you feel as though the environment is spinning around you, or that you are spinning when you are standing still. The second is tinnitus, a ringing in the ear, and you may also get a feeling of fullness or pressure in your ear. The third is hearing loss that comes and goes, usually affecting one ear at a time. Meniere's typically comes on without warning, and episodes can last between 20 minutes and 24 hours - although the average length of an attack is 2-4 hours, causing severe nausea or vomiting. Unfortunately, Meniere's is a progressive disease that gets worse over time. The episodes may happen in clusters in a week or over months, or even years, with most sufferers having 6-10 clusters a year. Some people only have vertigo without any hearing loss but hearing loss without vertigo is uncommon in Meniere’s.