How do the crystals in the inner ear get loose?

Brief Answer: As below: Detailed Answer: Hi, Thank you for your query. 1. The otoconia (crystals) in the inner ear get dislodged due to these probable reasons: a. Age related deterioration. b. Repeated blunt trauma to the head, a whiplash injury or contact/ high impact sports. c. Ear Infections. d. Ototoxic medication. e. Decreased blood supply to the inner ear. f. Idiopathic (unknown). 2. Violent coughing is a possibility, nor congestion. 3. Stress will worsen the symptoms. 4. The otoconia are normally present in the utricle and saccule which detect liner head motion and head tilt in the horizontal and vertical planes respectively. When these dislodged otoconia enter a semicircular canal, then they cause BPPV. this may occur with unusual head positions in sleep or while working. 5. The vertigo depends upon the location of the otoconia (canal)and relative to the ampulla (cupula) of each canal. Some otoconia may get attached to the cupula and cause persistent symptoms. I hope that I have answered your query. If you have any further questions, I will be available to answer them. Regards.