This study was designed to evaluate the relationship between swimming and benign paroxysmal positional vertigo (BPPV). This prospective study was comprised of 30 subjects (15 females, 15 males, mean age 15.6 years; range 11 to 23 years) who had been swimming regularly for at least two years. Twenty subjects (9 females, 11 males; mean age 15.4 years; range 11 to 21 years) with no vertigo and ear complaints comprised the control group. The Dix-Hallpike maneuver was used in all the swimmers and controls to diagnose BPPV. Four swimmers (13%) exhibited characteristic findings of BPPV, being unilateral in three, and bilateral in one. Interestingly, no swimmer experienced vertigo during swimming. The characteristics of nystagmus were typical of posterior semicircular canal BPPV in all cases. None of the subjects in the control group exhibited symptoms or findings of BPPV. Patients with BPPV underwent the Epley maneuver for therapy. All were free of vertigo after one month. There was no relationship between swimming and BPPV with respect to the frequency and duration of swimming. Swimming may be one of the etiological factors of BPPV. It appears that rapid head movements during swimming cause otoconia to be dislodged from the macula and enter the semicircular canals.
