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Home > Living Well > Health Library > 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 a balance problem that causes brief vertigo spells that come and go.
For many people, BPPV goes away by itself in a few weeks, but treatment can help. It can come back again.
BPPV isn't a sign of a serious health problem.
BPPV is caused by a problem in the inner ear. Tiny calcium "stones" inside your inner ear help you keep your balance. When you have BPPV, these stones move into the semicircular canal in your inner ear where they can cause a feeling of spinning.
The main symptom of BPPV is a feeling that you are spinning or tilting when you are not. It can happen when you move your head in a certain way, like rolling over in bed. You may find it hard to walk or stand without losing your balance.
BPPV is diagnosed with a physical exam. Your doctor will ask questions about your symptoms and past health. You may have a Dix-Hallpike test. In this test, your doctor watches your eyes while turning your head and helping you lie back.
BPPV may go away in a few weeks by itself. If treatment is needed, it usually involves your doctor moving your head in different directions.
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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. Sometimes these stones move into an area of your inner ear called the semicircular canal. When you move your head in certain ways, the stones in your semicircular canal move. Sensors in the semicircular canal are triggered by the stones, which causes a feeling of spinning.
Scientists think you're more likely to develop benign paroxysmal positional vertigo (BPPV) if you have one of these conditions:
If you've had one episode of vertigo caused by BPPV, you are likely to have more.
The main symptom of BPPV is the feeling that you or your surroundings are spinning, whirling, or tilting. This sensation is called vertigo. It usually lasts a minute or two.
It's important to understand the difference between vertigo and dizziness. People often use those two terms as if they meant the same thing. But they are different symptoms, and they may point to different problems.
Benign paroxysmal positional vertigo (BPPV) causes a whirling, spinning sensation even though you are not moving. If the vertigo is bad, it may also cause nausea or vomiting. The vertigo attacks happen when you move your head in a certain way, such as tilting it back or up or down, or by rolling over in bed. It usually lasts less than a minute. Moving your head to the same position again may trigger another episode of vertigo.
BPPV often goes away without treatment. Until it does, or is successfully treated, it can repeatedly cause vertigo with a particular head movement. Sometimes it will stop for a period of months or years and then suddenly come back.
Call 911 or other emergency services immediately if you have vertigo (a spinning sensation) and:
Call your doctor now or seek immediate care if:
Call your doctor to schedule an appointment if:
Watchful waiting is a wait-and-see approach. It may be okay to try it if your symptoms suggest BPPV. Over time, BPPV may go away on its own. But treatment with a simple procedure in your doctor's office (either the Epley or Semont maneuver) can usually stop your vertigo right away. Talk to your doctor. If your vertigo interferes with your normal daily activities or causes nausea and vomiting, you may need treatment.
BPPV is diagnosed with a physical exam. Your doctor will ask questions about your symptoms and past health.
A Dix-Hallpike test may be done to help your doctor find out the cause of your vertigo. During this test, the doctor watches your eyes while turning your head and helping you lie back. This will help your doctor know whether the cause of your vertigo is inside your brain, your inner ear, or the nerve connected to your inner ear. This test also can help your doctor find out which ear is affected.
BPPV may go away in a few weeks by itself. If treatment is needed, it usually involves your doctor moving your head in different directions. Examples are Epley and Semont maneuvers. These movements will move the particles out of the semicircular canals of your inner ear.
Over time, your brain may react less and less to the confusing signals triggered by the particles in the inner ear. This is called compensation. It occurs fastest if you keep doing normal head movements, even if those movements cause the whirling feeling of vertigo.
A Brandt-Daroff exercise may also be done. It can speed the compensation process.
Medicines called vestibular suppressants may be tried if your symptoms are severe. These medicines include antihistamines, sedatives, and scopolamine.
Antiemetic medicines may also be used. They reduce the nausea and vomiting that can occur with vertigo.
In rare cases, surgery may be used to treat BPPV.
You can reduce the whirling or spinning sensation of vertigo when you have benign paroxysmal positional vertigo (BPPV) by taking these steps.
For example, try adding grab bars near the bathtub and toilet and keeping walking paths clear. This may prevent accidents and injuries.
Staying as active as possible usually helps the brain adjust more quickly. But that can be hard to do when moving is what causes your vertigo. Bed rest may help, but it usually increases the time it takes for the brain to adjust.
Many people have the spinning sensation of BPPV. The loss of balance it causes puts you at risk for falling.
Be extra careful so that you don't hurt yourself or someone else if you have a sudden attack of vertigo. You can reduce your risk of injury by taking personal precautions and making your home environment safe.
Medicines do not cure benign paroxysmal positional vertigo (BPPV). But they may be used to control severe symptoms, such as the whirling, spinning sensation of vertigo and the nausea and vomiting that may occur.
Medicines to reduce the whirling sensation of vertigo are called vestibular suppressants. They include:
Antiemetic medicines, such as promethazine (Promethegan), may be used if you have severe nausea or vomiting.
Current as of:
December 2, 2020
Author: Healthwise StaffMedical Review: Anne C. Poinier MD - Internal MedicineKathleen Romito MD - Family MedicineE. Gregory Thompson MD - Internal Medicine
Current as of: December 2, 2020
Author: Healthwise Staff
Medical Review:Anne C. Poinier MD - Internal Medicine & Kathleen Romito MD - Family Medicine & E. Gregory Thompson MD - Internal Medicine
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