Benign paroxysmal positional vertigo (BPPV) is one of the most common causes of vertigo. It comes on suddenly when you change the position of your head — for example when turning over in bed, getting up or looking up — and usually lasts less than a minute.
Benign positional vertigo (BPPV) — repositioning maneuvers
Benign paroxysmal positional vertigo (BPPV) is one of the most common causes of vertigo. It comes on suddenly when you change the position of your head — for example when turning over in bed, getting up or looking up — and usually lasts less than a minute.
About the problem
BPPV is caused by tiny calcium carbonate crystals (otoliths) that move into the semicircular canals of the inner ear. When you move your head, they stimulate the balance receptors, causing brief, intense spinning.
Diagnosis is based on the history and positional tests, during which the doctor watches for characteristic eye movements (nystagmus).
The mainstay of treatment is repositioning maneuvers (e.g. the Epley or Semont maneuver) — a sequence of head and body positions that moves the crystals back to a place where they do not cause symptoms. Many patients improve after one or a few maneuvers.
Most common symptoms
- brief, intense spinning when you change head position
- vertigo when turning over in bed, lying down or getting up
- nausea during an attack
- a feeling of unsteadiness that persists between attacks
When to see a doctor
- when vertigo recurs with specific head movements
- when symptoms make sleeping, working or driving difficult
- when vertigo comes back after previous treatment
- urgently — when vertigo is accompanied by speech or vision problems, limb weakness, severe headache or difficulty walking