Benign Paroxysmal Positional Vertigo

Benign Paroxysmal Positional Vertigo – About

Benign paroxysmal positional vertigo (BPPV) is one of the most common causes of vertigo — the sudden sensation that you are spinning or that the inside of your head is spinning.
Benign paroxysmal positional vertigo causes brief episodes of mild to intense dizziness. Benign paroxysmal positional vertigo is usually triggered by specific changes in the position of your head. This might occur when you tip your head up or down, when you lie down, or when you turn over or sit up in bed.

Although benign paroxysmal positional vertigo can be a bothersome problem, it is rarely serious except when it increases the chance of falls. You can receive effective treatment for benign paroxysmal positional vertigo during a doctor’s office visit.

Benign Paroxysmal Positional Vertigo – Diagnosis

Your doctor may do a series of tests to determine the cause of your dizziness. During a physical examination, your doctor will likely look for:

• Signs and symptoms of dizziness that are prompted by head movements and then decrease in less than one to two minutes
• Dizziness with specific eye movements (nystagmus) that occur when you lie on your back with your head turned to one side and tipped slightly over the edge of the examination bed

If the cause of your signs and symptoms is difficult to determine, your doctor may order additional testing, such as:

• Videonystagmography (VNG). The purpose of this test is to detect abnormal eye movement. VNG (which uses small cameras) can help determine if dizziness is due to inner ear disease by measuring involuntary eye movements while your head is placed in different positions
• Magnetic resonance imaging (MRI). This test uses a magnetic field and radio waves to create cross-sectional images of your head and body. Your doctor can use these images to identify and diagnose a range of conditions. MRI may be performed to rule out other possible causes of vertigo.

Benign Paroxysmal Positional Vertigo – Treatment

Benign paroxysmal positional vertigo may go away on its own. But, to help relieve BPPV sooner, your doctor or physical therapist may treat you with a series of movements known as the canalith repositioning procedure.

Canalith repositioning

Performed in your doctor’s office, the canalith repositioning procedure consists of several simple and slow maneuvers for positioning your head. The goal is to move particles from the fluid-filled semicircular canals of your inner ear into a tiny open area (vestibule) that houses otolith organs in your ear where these particles do not cause trouble.

Each position is held for about 30 seconds after any symptoms or abnormal eye movements stop. This procedure is usually effective after one or two treatments.

Surgical alternative

In very rare situations (1% or less) in which the canalith repositioning procedure is not effective, your doctor may recommend a surgical procedure in which a plug is used to block the portion of your inner ear that is causing dizziness. The plug prevents the semicircular canal in your ear from being able to respond to particle movements or head movements in general.