Key Points about Benign Paroxysmal Positional Vertigo (BPPV)

  • BPPV is an inner ear disorder that can lead to dizziness, nausea and trouble keeping your balance.
  • As the first course of treatment, your specialist may use canalith repositioning (head movements to move particles in your inner ear to a part of your ear where they won't move).
  • Surgery may be needed to fully correct your BPPV.
Common related conditions
Balance Disorder Meniere's Disease Positional Vertigo Ringing in the Ear (Tinnitus)

Overview

Benign paroxysmal positional vertigo – or BPPV – is a common cause of vertigo, which is the feeling of spinning or falling. BPPV episodes can range in intensity from mild to severe. Episodes are typically triggered by specific changes in head positioning, such as tilting your head up or down, when you lie down or when you turn over in bed. While itself not a dangerous condition, the condition can increase your fall risk.

Benign Paroxysmal Positional Vertigo causes 

Possible causes of BPPV can include:

  • Blow to the head
  • Damage to the inner ear
  • Migraine

Idiopathic BPPV occurs when the cause of the condition is unknown.

Benign Paroxysmal Positional Vertigo risk factors

Factors that increase your risk for developing BPPV include:

  • Being female
  • Being over age 50
  • Having a disorder that affects the balance organs of your ear
  • Having suffered a head injury

Benign Paroxysmal Positional Vertigo symptoms

Episodes of BPPV usually don’t last longer than a minute each. Signs and symptoms of a BPPV episode can include:

  • Dizziness
  • Nausea
  • Spinning feeling
  • Trouble keeping your balance
  • Vomiting

Benign Paroxysmal Positional Vertigo diagnosis

Your ear, nose and throat (ENT) specialist may use one or more diagnostic tools to diagnose your BPPV:

  • Physical examination. During the physical exam, your specialist will check for signs and symptoms of dizziness, specific eye movements that point to BPPV and inability to control your eye movements.
  • Electronystagmography (ENG). This test checks for normal eye movement.
  • Magnetic resonance imaging (MRI) scan. Your specialist may use an MRI scan to rule out other conditions that can cause similar symptoms.

Benign Paroxysmal Positional Vertigo treatment

In some cases, BPPV goes away on its own within a few weeks or months. When symptoms don’t clear up, your specialist may recommend one or more of the following: 

Canalith repositioning. In this procedure, your specialist moves and holds your head in specific positions to allow particles and fluid in your inner ear to shift into more normal positions. Most people need to undergo a couple sessions for results. Your specialist may show you how to perform canalith repositioning at home, as needed.

Surgery. When canalith repositioning isn’t effective, your specialist may need to perform a surgical procedure to place a bone plug to block the area of your inner ear that’s causing your dizziness. This procedure is successful for almost all people with BPPV.

When should I seek care?

If you experience any of these symptoms, start by voicing your concerns and symptoms to your primary care provider. From there, your doctor may suggest seeing an ENT specialist for more specialized treatment.