Benign Paroxysmal Positional Vertigo

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Vertigo is a feeling of movement or spinning when you are still. Benign paroxysmal positional vertigo (BPPV) happens when the vertigo is caused by changes your head's position. This might include standing after bending down, turning your head in bed or extending your neck to look up. 

Causes of BPPV

The inner ear contains tiny crystals that can sense movement and help you keep your balance. BPPV occurs because of a shift in location of these crystals or the clumping of these crystals. When this happens, your brain gets signals that you're moving when you're now. This causes the feeling of movement.

Inner Ear

bppv inner ear diagram
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In some cases, the cause of BPPV is unknown. In others, it may be caused by:

  • Head injury
  • Viral infection
  • Disorders of the inner ear
  • Prolonged immobility of the head
  • Age-related changes to inner ear

Symptoms of BPPV

Symptoms may include:

  • Sensation of spinning or rotation when you change head position that lasts less than one minute
  • Loss of balance
  • Nausea
  • Vomiting
  • Ringing or buzzing sounds in the ear
  • Vision or hearing problems

Diagnosing BPPV

Your doctor may recommend tests to help determine the cause of vertigo symptoms, including:

  • Dix-Hallpike maneuver — moving your head or body in certain ways to test response
  • MRI scan
  • Electronystagmography (ENG)

BPPV Treatment

Many times BPPV can resolve on its own, usually within months of onset. Talk with your doctor about the best treatment plan for you.

Vestibular Rehabilitation

Your doctor may suggest specific vestibular exercises. These exercises use a series of eye, head and body movements to get the body used to moving without dizziness. You may work with a physical therapist to learn these.

Canalith Repositioning

Your doctor will move your head in different positions to try to resettle the tiny crystals. The procedure is sometimes repeated and you may be taught how to do it at home.


During surgery, your doctor may use a piece of wax to plug one area of your ear. This prevents fluid in your inner ear from moving. Another type of surgery involves cutting the nerve from the inner ear.

Content was created using EBSCO’s Health Library. Edits to original content made by Rector and Visitors of the University of Virginia. This information is not a substitute for professional medical advice.