Mayo Clinic: What causes BPPV, and is there a treatment for
Benign paroxysmal positional vertigo, or BPPV, is one of the
most common causes of vertigo (dizziness). BPPV is
characterized by sudden bursts of vertigo that are caused by
head movements, such as sitting up or tilting your head. What
leads to the development of BPPV isnít known, but itís
more common in older adults.
develop BPPV, the bursts of dizziness typically occur after
you change the position of your head, such as when you roll
over in bed. BPPV also may cause nausea and possibly vomiting,
with a feeling of lingering fatigue, queasiness or a feeling
of imbalance. Without treatment, these symptoms may last for
as little as one day to as long as weeks or months.
Fortunately, with proper diagnosis, a simple procedure may be
all it takes to treat BPPV.
sense of balance relies on a finely tuned system that
coordinates sensory information (from nerves throughout your
body) and visual information to help you determine the
position of your body relative to your surroundings.
a result of tiny crystals in your inner ear being out of
place. The crystals make you sensitive to gravity and help you
to keep your balance. Normally, a jelly-like membrane in your
ear keeps the crystals where they belong. If the ear is
damaged ó often by a blow to the head ó the crystals can
shift to another part of the ear. When they are out of place,
the crystals make you sensitive to movement and position
changes that normally donít affect you, sparking vertigo.
there are numerous causes of imbalance and dizziness ó and
more than one cause may occur at the same time ó proper
diagnosis is critical to effective treatment. With BPPV, the
primary diagnostic test is called the Dix-Hallpike test.
During the test, you are placed in the position that usually
causes your vertigo. Then, your doctor checks for involuntary,
jerking eye movements (nystagmus) that are associated with
BPPV. The test may be done in different ways to determine
which side is causing the problem.
for BPPV can be done in your doctorís office, or with an
audiologist or certain physical therapists. The treatment
includes a series of body movements that reposition the
crystals in your inner ear, where they no longer cause
symptoms. Two procedures used are the canalith repositioning
procedure and the Lempert roll. With canalith repositioning,
just one time through the procedure is often enough to correct
BPPV. However, it may be necessary to perform the procedure up
to several times with brief breaks between before BPPV is
eliminated. Your doctor will be able to detect treatment
completion when thereís no sign of nystagmus in your eyes.
After the treatment, youíll likely be advised to keep your
head upright for the rest of the day.
the canalith repositioning procedure is highly effective, BPPV
can linger or return. This is more likely to happen in older
adults. If this happens, you may be taught how to do the
canalith repositioning procedure on your own at home.
dizziness persistently lingers or continues to return, a visit
to a specialist, such as an audiologist or vestibular
therapist, may be warranted. A specialized evaluation can
determine if BPPV is being treated properly or if other
factors affecting balance may be in play.
people continue to have symptoms of impaired imbalance and
dizziness after BPPV has been resolved. In these cases,
working with a physical therapist specializing in vestibular
and balance rehabilitation can help you decrease dizziness
symptoms and regain balance. (adapted from Mayo Clinic Health