Benign Paroxysmal Positional Vertigo

Benign paroxysmal positional vertigo (BPPV) is one of the most common causes of vertigo — the sudden sensation that you’re spinning or that the inside of your head is spinning.

BPPV causes brief episodes of mild to intense dizziness. It is usually triggered by specific changes in your head’s position. This might occur when you tip your head up or down, when you lie down, or when you turn over or sit up in bed.

Although BPPV can be bothersome, it’s rarely serious except when it increases the chance of falls. You can receive effective treatment for BPPV during a doctor’s office visit.

Benign Paroxysmal Positional Vertigo Symptoms

People with BPPV can experience a spinning sensation — vertigo — any time there is a change in the position of the head.

The symptoms can be very distressing. People can fall out of bed or lose their balance when they get up from bed and try to walk. If they tilt their head back or forward while walking, they may even fall, risking injury. Vertigo can cause the person to feel quite ill with nausea and vomiting.

While the hallmark of BPPV is vertigo associated with changes in head position, many people with BPPV also feel a mild degree of unsteadiness in between their recurrent attacks of positional vertigo.

The onset of BPPV may be abrupt and frightening. People may think they are seriously ill; for example, they may fear they are having a stroke. A doctor’s diagnosis of BPPV can be reassuring, especially when people understand that help is available to relieve their symptoms.

Without treatment, the usual course of the illness is lessening of symptoms over a period of days to weeks, and sometimes there is spontaneous resolution of the condition. In rare cases, the person’s symptoms can last for years.

What Brings on BPPV?

In many people, especially older adults, there is no specific event that causes BPPV to occur, but there are some things that may bring on an attack:

• Mild to severe head trauma
• Keeping the head in the same position for a long time, such as in the dentist chair, at the beauty salon or during strict bed rest
• Bike riding on rough trails
• High intensity aerobics
• Other inner ear disease (ischemic, inflammatory, infectious)

Related: What Triggers Vertigo?

Treatment for BPPV

BPPV can be treated with simple exercises, taught by a doctor or physiotherapist who is familiar with the techniques required. However, if symptoms persist and cause distress, you may be referred to a specialist.

Very short-term use of motion sickness medications is sometimes useful to control the nausea associated with BPPV, and a number of easily learnt manoeuvres and exercises can be very effective treatments.

BPPV can subside with time, but it is important to seek treatment in the early stages to prevent falls or injury. In extreme cases, surgery may be carried out to block the affected canal, however BPPV can usually be very effectively treated using a range of positional manoeuvres. 

These positional manoeuvres aim to move the crystals out of the semicircular canal of the inner ear and into an area of the inner ear where they no longer cause dizziness. 

Sometimes, a second treatment may be necessary. Your health professional can perform these manoeuvres in their rooms. Treatment may also include other simple exercises that you will need to do regularly at home.

Related: What Causes Vertigo In Adults