What Is BPPV?
Benign Paroxysmal Positional Vertigo (BPPV) is the most common cause of vertigo — a sudden spinning sensation triggered by specific head movements.
It occurs when tiny calcium crystals inside the inner ear shift out of place and disrupt the balance signals sent to the brain. Though the episodes can feel alarming, BPPV is generally short-lived and highly treatable, often resolving with simple repositioning techniques rather than medication or surgery.
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Common Symptoms
A sudden spinning or whirling sensation, usually lasting seconds to a few minutes
Dizziness triggered by rolling over in bed, tilting the head back, or looking up
Loss of balance or unsteadiness while standing or walking
Nausea or vomiting during vertigo episodes
Involuntary eye movements (nystagmus) during an attack
A brief feeling of light-headedness following the spinning sensation
What Causes BPPV?
- Displaced calcium crystals (otoconia) in the inner ear's semicircular canals
- Ageing, which naturally loosens these crystals over time
- Head injury or trauma affecting the inner ear
- Prolonged bed rest or lying in one position for extended periods
- Inner ear disorders or infections affecting balance function
- In some cases, no clear triggering cause is identified
How It's Diagnosed
Diagnosis relies on a physical exam using specific positional tests, such as the Dix-Hallpike manoeuvre, where the doctor moves your head into positions that typically trigger vertigo, then observes eye movement patterns to confirm which inner ear canal is affected.
Imaging like an MRI is usually unnecessary unless symptoms don't fit the typical BPPV pattern or point to another neurological cause.
Treatment Options
Most cases of BPPV resolve within one or two repositioning sessions, with many people experiencing significant relief immediately after treatment.
- Canalith repositioning procedures, such as the Epley manoeuvre, to guide displaced crystals back into place
- Vestibular rehabilitation therapy to retrain balance and reduce dizziness sensitivity
- Simple home exercises taught by a therapist to manage and prevent flare-ups
- Medication for nausea, only during acute episodes, as advised by a doctor
- Avoiding sudden head movements while symptoms are active
When to See a Doctor
- Vertigo that doesn't improve after repositioning treatment
- Symptoms accompanied by hearing loss, severe headache, or slurred speech
- Vertigo with numbness, weakness, or difficulty walking
- Frequent, recurring episodes affecting daily life
While BPPV itself isn't dangerous, ruling out other causes of dizziness ensures you get the right treatment and avoid unnecessary falls or complications.