Benign Paroxysmal Positional Vertigo

Healthcare provider turning woman's head as she lies on exam table.Benign paroxysmal positional vertigo (BPPV) is a problem with the inner ear. The inner ear contains the vestibular system. This system is what helps you keep your balance. BPPV causes a feeling of spinning. It is a common problem of the vestibular system.

Understanding the vestibular system

The vestibular system of the ear is made up of very tiny parts. They include the utricle, saccule, and semicircular canals. The utricle is a tiny organ that contains calcium crystals. In some people, the crystals can move into the semicircular canals. When this happens, the system no longer works as it should. This causes BPPV. Benign means it is not life threatening. Paroxysmal means it happens suddenly. Positional means that it happens when you move your head. Vertigo is a feeling of spinning.

What causes BPPV?

Causes include injury to your head or neck. Other problems with the vestibular system may cause BPPV. In many people, the cause of BPPV is not known.

Symptoms of BPPV

You many have repeated feelings of spinning (vertigo). The vertigo usually lasts less than 1 minute. Some movements, such as rolling over in bed, can bring on vertigo.

Diagnosing BPPV

Your primary healthcare provider may diagnose and treat your BPPV. Or you may see an ear, nose, and throat doctor (otolaryngologist). In some cases, you may see a nervous system doctor (neurologist).

The healthcare provider will ask about your symptoms and your medical history. He or she will examine you. You may have hearing and balance tests. As part of the exam, your healthcare provider may have you move your head and body in certain ways. If you have BPPV, the movements can bring on vertigo. Your provider will also look for abnormal movements of your eyes. You may have other tests to check your vestibular or nervous systems.

Treatment for BPPV

Your healthcare provider may try to move the calcium crystals. This is done by having you move your head and neck in certain ways. This treatment is safe and often works well. You may also be told to do these movements at home. You may still have vertigo for a few weeks. Your healthcare provider will recheck your symptoms, usually in about a month. Special physical therapy may also be part of treatment. In rare cases, surgery may be needed for BPPV that does not go away.


When to call the healthcare provider

Call your healthcare provider right away if you have any of these:

  • Symptoms that do not go away with treatment

  • Symptoms that get worse

  • New symptoms