Dizziness & Vertigo

Benign Paroxysmal Positional Vertigo

(BPPV)

What is BPPV? 

BPPV is an inner ear problem. It causes brief but sometimes severe feelings of spinning. Some people feel that their head or body is spinning. Others feel the room is spinning. 

BPPV happens suddenly when you change the position of your head. 

How does it occur? 

In the inner part of your ear are 3 semicircular canals. Movement of the fluid in these canals helps your brain maintain your balance and know what position you are in.

There are usually small crystals of calcium (otoconia) in the central compartment.  Sometimes, these crystals float into the semi-circular canal. This can happen after a head injury, with a severe cold, or simply as a part of normal aging. The crystals can cause vertigo when you change head position and they strike against nerves in the semi-circular canals. Usually the calcium crystals dissolve in a few weeks and stop causing vertigo. However, sometimes the crystals do not dissolve and the vertigo returns from time to time.

What are the symptoms? 

A sudden feeling that you are spinning, or that the room is spinning, is the main symptom. You may feel the vertigo when you first wake up. It may seem that any turn of your head brings on brief but intense spells of vertigo. It may happen when you tilt your head, look up or down, or roll over in bed. 

You may have nausea and vomiting along with the vertigo. Even if a spell of vertigo is brief, you may have a feeling of queasiness for several minutes or even hours afterward. 

How is it diagnosed? 

Your doctor will ask about your symptoms and examine you. You may also be given a Dix-Hallpike position test. A hearing test may also be done. 

How is it treated? 

Usually an Epley maneuver is done to reposition the crystals. It can be very helpful. 

Rarely, when the Epley maneuver doesn’t help and the vertigo has not gone away, severe and persistent cases may rarely require surgery. 

How long will the effects last? 

Even without treatment, positional vertigo usually goes away within several weeks. Sometimes it recurs despite treatment. 

How do I take care of myself? 

Do not try to drive, operate tools or machinery, that could endanger yourself or others if you suddenly become dizzy. Do not lie down flat for 3 days. Lie down at a semi-reclined position.

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