What is Benign Paroxysmal Positional Vertigo?

Benign paroxysmal positional vertigo (BPPV) causes a dizzy sensation due to some slight dysfunction in one or both ears. Small particles in the ears may break loose from their position, and their movement creates a sensation that the body is moving when it is not. This may result in vertigo in spells that is especially noted when body position changes, as with rolling over, turning the head, or standing up, and which lasts about a minute with each spell. Often, no cause for this condition is found, though head injuries can cause it, and it most commonly occurs in people over the age of 55. Treatments can be varied depending on the condition’s severity, and many people recover without much intervention, though occasionally surgery is recommended if symptoms last longer than a year or are very severe.

Any type of head injury that causes dizziness, or vertigo associated with high fever or suspected stroke may not be benign paroxysmal positional vertigo. Sometimes conditions like brain tumor may also cause vertigo. If people are having bouts of dizziness or spinning sensations, they do need to see a doctor to rule out other potential problems. Two issues, especially for seniors who have this condition, are that dizzy spells can increase their chance of falling and they can cause vomiting. Vomiting can easily lead to dehydration if it is occurring often.

When people see their doctors about a suspected case of benign paroxysmal positional vertigo, doctors will typically perform various checks to make certain BPPV is the right diagnosis. In the absence of evidence of other vertigo causes, this diagnosis is often the correct one because this condition is so common. Finding slight movement in the eyes, called nystagmus, in addition to the patient’s reported symptoms of dizziness, spinning, or nausea, further assists physicians in making a diagnosis.

If benign paroxysmal positional vertigo is very slight, doctors could opt for little to no treatment. Generally, the condition is bothersome enough that some intervention is needed. The most common intervention is a series of slow head position exercises that patients can learn to do at home. These are thought to help the particles in the ears achieve a more stable position, and performing these exercises once a day may reduce episodes of vertigo.

Some people are not helped by exercises and continue to suffer dizziness over a long span of time. If BPPV continues, doctors might recommend surgery to stabilize structures in the ear so that the small particles cannot move as freely. Surgery is usually a treatment of last resort, but has a high rate of success.

Most people with shorter period bouts of benign paroxysmal positional vertigo will get better without surgery and exercises reduce number of dizzy spells. It’s still important to be careful, especially when rising out of bed or when quickly turning the head. Slow deliberate movements may help reduce BPPV episodes and help reduce risk of injury from sudden falls.