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Benign Paroxysmal Positional Vertigo


The Manual's Editorial Staff

Reviewed/Revised Nov 2023
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What is benign paroxysmal positional vertigo?

The Ears

Benign paroxysmal positional vertigo (BPPV) is a kind of dizziness where you feel like you're spinning around. It isn't serious and goes away on its own, but it may be uncomfortable. This type of dizziness comes on suddenly when you move in certain ways.

  • You get sudden episodes where you feel like you're spinning and feel sick to your stomach and may throw up

  • The episodes are triggered when you move your head

  • Usually the episodes last less than a minute

  • BPPV is more common in older people—it can affect balance and make you more likely to fall

  • A set of movements called the Epley maneuver stop dizziness in most people

What causes BPPV?

BPPV happens because there's a problem deep inside your ear where your balance is controlled. Tiny calcium particles in your inner ear get loose and float around where they don't belong. This causes symptoms.

The particles shift around when you move your head in certain ways, such as:

  • Rolling over in bed

  • Bending over to pick up something

BPPV is more common in older people and in women.

What are the symptoms of BPPV?

Symptoms come on suddenly when you move your head. The symptoms of BPPV are:

  • Short periods of dizziness (vertigo)—you may feel like either you or your surroundings are moving or spinning

  • Feeling sick to your stomach

  • Throwing up

Symptoms are unpleasant but aren’t dangerous. However, you can lose your balance and fall if an episode of BPPV comes on while you're standing or walking.

How can doctors tell if I have BPPV?

Doctors diagnose BPPV based on your symptoms and a physical exam. They might do other tests, such as an MRI Magnetic Resonance Imaging (MRI) MRI is a test that uses a machine with a powerful magnet to make pictures of the inside of your body. A computer records changes in the magnetic field around your body. The computer then uses... read more Magnetic Resonance Imaging (MRI) (magnetic resonance imaging), if they need to make sure you aren’t getting dizzy for other, more dangerous reasons.

How do doctors treat BPPV?

Doctors usually treat BPPV by doing the Epley maneuver. This maneuver is a special way of moving your head and body. It shifts the loose particles to a different part of your ear so they don't cause problems.

Epley Maneuver: A Simple Treatment for a Common Cause of Vertigo

The maneuver is done by following the clockwise order of the red arrows below.

Epley Maneuver: A Simple Treatment for a Common Cause of Vertigo

To do the Epley maneuver do the following and hold each position for about 30 seconds:

  • Sit down on a table or bed and turn your head halfway to the right

  • Lie down on your back with your head still turned to the right and let your head hang off the end of the table or bed

  • Turn your head to the left

  • Now turn your head and body all the way to the left so your nose points to the floor

  • Slowly sit up, but keep your head turned all the way to the left

  • Once you’re sitting up, turn your head to face forward

The symptoms of BPPV usually go away in a few months.

Doctors sometimes give you medicines to relieve the dizziness and sick feeling in your stomach, but these may only help for a short time.

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