Benign Positional Vertigo
Benign paroxysmal positional vertigo (BPPV) causes brief spinning sensations triggered by certain head movements.
About benign positional vertigo
Benign paroxysmal positional vertigo (BPPV) causes brief spinning sensations triggered by certain head movements.
What can cause it?
BPPV occurs when tiny inner-ear crystals move into a balance canal where they do not belong.
It may follow head injury or aging and sometimes has no clear trigger.
What a patient may notice
Symptoms vary from person to person. Possible signs may include:
- Short episodes of spinning
- Symptoms when rolling in bed, looking up, or bending
- Nausea or unsteadiness
How clinicians find the cause
A clinician uses the symptom pattern and positional examination, often including a Dix-Hallpike maneuver, while checking for neurologic or ear findings that suggest another cause.
Treatment and next steps
- 1
A canalith-repositioning maneuver can move the crystals back and often provides rapid improvement.
- 2
Balance therapy or home maneuvers may be taught after the diagnosis is confirmed.
- 3
Long-term dizziness-suppressing medicine is usually not the main treatment for BPPV.
Supporting recovery
- Move slowly and sit down when spinning begins.
- Avoid driving, ladders, or fall-risk activity until episodes are controlled.
- Perform home maneuvers only after a clinician confirms which ear and canal are involved.
What to expect
BPPV is uncomfortable but usually responds well to a canalith-repositioning maneuver such as the Epley maneuver. Treatment may need to be repeated. Episodes can return weeks, months, or years later without warning.
Possible complications
- Falls or injury during a sudden spinning episode
- Dehydration when severe nausea and vomiting continue
- Activity limits or driving risk until the vertigo is controlled
When to Contact a Medical Professional
Arrange an evaluation when symptoms are new, worsening, interfering with normal activities, or not improving as expected.
Call 911 for vertigo with new weakness, trouble speaking, severe headache, fainting, chest pain, double vision, or inability to walk.Get emergency help for severe trouble breathing, new chest pressure, fainting, seizure, sudden weakness on one side, uncontrolled bleeding, blue or gray lips, or a person who is difficult to wake.
Ways to lower risk
- Many episodes cannot be prevented.
- Fall prevention and head protection reduce injury during dizzy spells.
Trusted health information
This CHS patient-education page uses original wording and links to MedlinePlus for additional information.