What Happens

Benign paroxysmal positional vertigo (BPPV) causes a whirling, spinning sensation even though you are not moving. If the vertigo is bad, it may also cause nausea or vomiting. The vertigo attacks happen when you move your head in a certain way, such as tilting it back or up or down, or by rolling over in bed. It usually lasts less than a minute. Moving your head to the same position again may trigger another episode of vertigo.

BPPV often goes away without treatment. Until it does, or is successfully treated, it can repeatedly cause vertigo with a particular head movement. Sometimes it will stop for a period of months or years and then suddenly come back.

What Increases Your Risk

Scientists think you're more likely to develop benign paroxysmal positional vertigo (BPPV) if you have one of these conditions:

• You are an older adult.
• You have a head injury.
• You have an inflammation of the inner ear or of the nerve that connects the inner ear to the brain, a condition called vestibular neuritis.
• You have ear surgery.

If you've had one episode of vertigo caused by BPPV, you are likely to have more.

When To Call a Doctor

Call or other emergency services immediately if you have vertigo (a spinning sensation) and:

• You passed out (lost consciousness).
• You have symptoms of a stroke, such as:
  • Sudden numbness, tingling, weakness, or loss of movement in your face, arm, or leg, especially on only one side of your body.
  • Sudden vision changes.
  • Sudden trouble speaking.
  • Sudden confusion or trouble understanding simple statements.
  • Sudden problems with walking or balance.
  • A sudden, severe headache that is different from past headaches.
• You have chest pain.
• You have a headache, especially if you also have a stiff neck and fever.
• You have sudden hearing loss.
• You have numbness or tingling that does not go away, anywhere on your body.
• You have vomiting that doesn't stop.
• You had a recent head injury.

Call your doctor now or seek immediate care if:

• You have an attack of vertigo that is different from those you have had before or from what your doctor told you to expect.
• You need medicine to control nausea and vomiting caused by severe vertigo.

Call your doctor to schedule an appointment if:

• This is the first time you have had an attack of vertigo.
• You have a low-pitched roaring, ringing, or hissing sound in your ear, especially if you have not had this before. This is called tinnitus.
• You have frequent or severe episodes of vertigo that interfere with your activities.

Watchful Waiting

If your symptoms suggest benign paroxysmal positional vertigo (BPPV), watchful waiting may be appropriate. Over time BPPV may go away on its own. But treatment with a simple procedure in your doctor's office (either the Epley or Semont maneuver) can usually stop your vertigo right away. Talk to your doctor. If your vertigo interferes with your normal daily activities or causes nausea and vomiting, you may need treatment.

Who To See

The following health professionals are able to diagnose and treat BPPV and the causes of vertigo:

• Family doctor
• General practitioner
• Physician assistant
• Nurse practitioner
• Internist
• Otolaryngologist
• Neurologist

To prepare for your appointment, see the topic Making the Most of Your Appointment.