Benign Paroxysmal Positional Vertigo (BPPV) - Topic Overview

SYMPTOMS & TREATMENTS

Picture of the anatomy of the ear

What is benign paroxysmal positional vertigo (BPPV)?

Vertigo is the feeling that you are spinning or the world is spinning around you. Benign paroxysmal positional vertigo is caused by a problem in the inner earClick here to see an illustration.. It usually causes brief vertigo spells that come and go.

For some people, BPPV goes away by itself in a few weeks. But it can come back again.

BPPV is not a sign of a serious health problem.

What causes BPPV?

Benign paroxysmal positional vertigo (BPPV) is caused by a problem in the inner ear. Tiny calcium "stones" inside your inner ear canals help you keep your balance. Normally, when you move a certain way, such as when you stand up or turn your head, these stones move around. But things like infection or inflammation can stop the stones from moving as they should. This sends a false message to your brain and causes the vertigo.

What are the symptoms?

The main symptom is a feeling that you are spinning or tilting when you are not. This can happen when you move your head in a certain way, like rolling over in bed, turning your head quickly, bending over, or tipping your head back.

BPPV usually lasts a minute or two. It can be mild, or it can be bad enough to make you feel sick to your stomach and vomit. You may even find it hard to stand or walk without losing your balance.

How is BPPV diagnosed?

Your doctor can usually tell that you have BPPV by asking you questions about your vertigo and doing a physical exam. You may have a test where your doctor watches your eyes while turning your head and helping you lie back. This is called the Dix-Hallpike test.

There are other things that can cause vertigo, so if your doctor doesn't think you have BPPV, you may have other tests too.

How is it treated?

Your doctor can usually do one of two procedures in the office that works for most cases of BPPV. These procedures are called the Epley maneuver and the Semont maneuver. If you don't want treatment or if treatment doesn't work, BPPV usually goes away by itself within a few weeks. Over time, your brain will likely get used to the confusing signals it gets from your inner ear. Either way, you can do some simple exercises that train your brain to get used to the confusing vertigo signals.

Medicine can help with severe nausea and vomiting caused by your vertigo. But using this kind of medicine can also make BPPV take longer to go away. Only you know whether you feel sick enough that it is worth it to take medicine (and possibly have vertigo longer).

Be extra careful so that you don't hurt yourself or someone else if you have a sudden attack of vertigo.

  • Do not drive or cycle if there is any chance that vertigo could strike and make you lose control. (This depends on what kind of movement triggers vertigo for you.)
  • At home, keep floors and walkways free of clutter so you don't trip.
  • Avoid heights.
  • Don't use tools or machines that could be dangerous if you suddenly get dizzy or lose your balance.

Frequently Asked Questions

Learning about benign paroxysmal positional vertigo (BPPV):

Being diagnosed:

Getting treatment:

Ongoing concerns:

Living with BPPV:

By: Healthwise StaffLast Revised: December 30, 2009
Medical Review: Anne C. Poinier, MD - Internal Medicine
Barrie J. Hurwitz, MD - Neurology

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