What is 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 caused by a problem in the inner ear. It usually causes brief vertigo spells that come and go.

For some people, BPPV goes away by itself in a few weeks. But it can come back again.

BPPV is not a sign of a serious health problem.

What causes BPPV?

Normally, there are little calcium "stones" in the inner ear canals that are moved around by gravity. BPPV can be caused by things like infection or inflammation that stop the stones from moving around like normal. This sends a false message to the brain that affects your balance.

What are the symptoms?

The main symptom is a feeling that you are spinning or tilting when you are not. This can happen when you move your head in a certain way, like rolling over in bed, turning your head quickly, bending over, or tipping your head back.

BPPV usually lasts a minute or two. It can be mild, or it can be bad enough to make you feel sick to your stomach and vomit. You may even find it hard to stand or walk without losing your balance.

How is BPPV diagnosed?

You and your doctor will talk about your symptoms. Your doctor will do a full physical exam and will test your nervous system to see if there’s a problem with how your nerves send messages to your brain. Your doctor may be able to tell that you have BPPV by watching how your eyes move as you turn your head and lie back. This is called the Dix-Hallpike test.

There are other things that can cause vertigo, so you may have other tests too.

How is it treated?

BPPV usually goes away by itself within a few weeks. Over time, your brain will likely get used to the confusing signals it gets from your inner ear. But you can do some simple exercises that might make the vertigo go away faster.

One kind of exercise for BPPV can move the calcium stones in a way that they don't trigger vertigo. Another kind of exercise can try to train your brain to get used to the confusing vertigo signals.

Medicine can help with severe vertigo that makes you sick to your stomach. But using this kind of medicine can also make BPPV take longer to go away. Only you know whether you feel sick enough that it is worth it to take medicine (and possibly have vertigo longer).

Be extra careful so that you don't hurt yourself or someone else if you have a sudden attack of vertigo.

• Do not drive or cycle if there is any chance that vertigo could strike and make you lose control. (This depends on what kind of movement triggers vertigo for you.)
• At home, keep floors and walkways free of clutter so you don't trip.
• Avoid heights.
• Don't use tools or machines that could be dangerous if you suddenly lose your balance.

Frequently Asked Questions

Learning about benign paroxysmal positional vertigo (BPPV):	What is BPPV? What causes BPPV? Can I prevent BPPV? What are the symptoms of BPPV? What happens in BPPV? What increases my risk for BPPV?
Being diagnosed:	How is BPPV diagnosed? What is a Dix-Hallpike test?
Getting treatment:	How is BPPV treated? What medications will I need to take? Will I need surgery?
Ongoing concerns:	Should I do balance exercises for vertigo? Will I have permanent hearing loss?
Living with BPPV:	What can I do at home to relieve symptoms of BPPV? Should I take any safety precautions for vertigo?