Benign Paroxysmal Positional Vertigo
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Benjamin Wedro, MD, FACEP, FAAEM
Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Charles Patrick Davis, MD, PhD
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
- Benign Paroxysmal Positional Vertigo Overview
- Benign Paroxysmal Positional Vertigo Causes
- Benign Paroxysmal Positional Vertigo Symptoms
- When to Seek Medical Care
- Benign Paroxysmal Positional Vertigo Diagnosis
- Benign Positional Vertigo Treatment
- Self-Care at Home
- Medical Treatment
- Medications
- Benign Paroxysmal Positional Vertigo Prevention
- Benign Paroxysmal Positional Vertigo Outlook
- Synonyms and Keywords
- Authors and Editors
- Read more on Benign Positional Vertigo from Healthwise
- Viewer Comments: Benign Positional Vertigo - Exercises
- Viewer Comments: Benign Postional Vertigo - Experience
- Viewer Comments: Benign Positional Vertigo - Diagnosis and Treatment
Benign Paroxysmal Positional Vertigo
Benign Paroxysmal Positional Vertigo Treatment
The definitive treatment for BPPV requires that crystals causing inflammation in the semicircular canals be moved out of those canals. This can be done by the Epley maneuvers, where the head is taken through a series of position changes that allow the crystals to be emptied out of the canals. Epley maneuvers require a special skill set, first to know which canal the crystals are in, and second, how to "shake" the head to get them removed. If a person without these skills is not available, medication may be helpful in decreasing or resolving symptoms.
Several medications, including common motion sickness remedies, may relieve symptoms of BPPV and may be used for less severe episodes of vertigo or in addition to the Epley maneuvers. Examples of these medications include:
- meclizine (Antivert, Bonine, Dramamine II, D-Vert)
- diazepam (Valium)
- dimenhydrinate (Dramamine)
Benign Paroxysmal Positional Vertigo Overview
Benign paroxysmal positional vertigo (BPPV) is one of the most common causes of vertigo, the symptom that describes the feeling of intense spinning of the head. BPPV describes the situation where the spinning sensation lasts only a few minutes and often stops by itself. There may be recurrent episodes without any specific reason or cause.
While there are many causes of vertigo, BPPV is the term that is used for vertigo that comes and goes (paroxysmal), without a specific associated illness (benign). It is often a frustrating situation for patients because the episodes are frightening and difficult to predict. However, it is related to the labyrinth system inside the inner ear.
The labyrinth system is located in the inner ear and is responsible for maintaining balance in the body. There are three semicircular canals that contain nerve endings and fluid that tell the body where it is in relation to gravity, acting almost like a gyroscope. Small crystals (cupuloliths) sit on top of nerve stalks and should they fall off, they can cause irritation to the fluid contained within the canals and this can lead to vertigo, the sensation that the head is spinning in relation to the rest of the world. Some researchers also suggest that in addition, some free-floating particles in the labyrinth system exert a force to additionally cause vertigo symptoms.
Many people have experienced the spinning sensation (vertigo) as a child. After spinning around for a period of time and then stopping quickly, there is a sensation that the spinning continues for a few seconds and sometimes the child falls down. This occurs because the fluid in the semicircular canals continues to spin after the head has stopped. This gives the person a sensation of vertigo. This may also happen during or after an amusement park ride and there can be associated nausea and vomiting if the vertigo is severe enough.
Benign Paroxysmal Positional Vertigo Causes
The cause of BPPV is often a mystery and in about half of the occurrences of BPPV, the cause is never found. It is unclear why small particles (crystals) become dislodged within the inner ear. It may be due to minor head injury or because of repetitive head movement (for example; the up and down head movement that occurs when working in front of a computer screen or when cleaning or dusting above head level).
Other causes may include the following:
- viral infections,
- nerve inflammation (neuritis),
- complication of ear surgery (more common in older people and women),
- medication side effects, and/or
- rapid head movements.
Viewer Comments & Reviews
Benign Positional Vertigo - Exercises
The eMedicineHealth physician editors ask:
What exercises helped with your benign positional vertigo?
Benign Postional Vertigo - Experience
The eMedicineHealth physician editors ask:
Please describe your experience with benign positional vertigo.
Benign Positional Vertigo - Diagnosis and Treatment
The eMedicineHealth physician editors asked:
How was your benign positional vertigo diagnosed and treated?
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Benign Paroxysmal Positional Vertigo
Vertigo Overview
Vertigo is the feeling that you or your environment is moving or spinning. It differs from dizziness in that vertigo describes an illusion of movement. When you feel as if you yourself are moving, it's called subjective vertigo, and the perception that your surroundings are moving is called objective vertigo.
Unlike nonspecific lightheadedness or dizziness, vertigo has relatively few causes.
Vertigo Causes
Vertigo can be caused by problems in the brain or the
inner ear.
- Benign paroxysmal positional vertigo (BPPV) is the most common form of vertigo and is
characterized by the sensation of motion initiated by sudden head movements or moving the head in a certain direction. This type of vertigo is rarely serious and can be treated.
- Vertigo may also be caused by inflammation within the inner ear (labyrinthitis or vestibular neuritis), which is characterized by the ...
Read What Your Physician is Reading on Medscape
Benign Positional Vertigo »
Benign paroxysmal positional vertigo (BPPV) is probably the most common single cause of vertigo in the United States.
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