Benign Paroxysmal Positional Vertigo

Vertigo, or the sudden sensation that the room is spinning, is a frustrating, unpleasant and sometimes debilitating symptom. It can be caused by several different inner ear disorders. The most common of them is benign paroxysmal positional vertigo, or BPPV.

If you think you have BPPV, the ear, nose and throat (ENT) specialists at The Ohio State University Wexner Medical Center can help. We have various treatments available that can relieve your vertigo symptoms or even cure its root causes. Additionally, our Department of Otolaryngology – Head and Neck Surgery is ranked as one of the best ENT programs in the country, and many doctors in Columbus, Ohio, and the region refer their patients to us for help with persistent inner ear issues. Several neurotologists on our staff specialize in vertigo conditions, so you’ll be in good hands as we walk you through treatment.

What is benign paroxysmal positional vertigo?

Parts of your inner ear anatomy — the semicircular canals and the vestibule — are responsible for controlling your balance. If those areas become damaged, balance issues like vertigo or dizziness can result.

With BPPV, which is a very common inner ear disorder, symptoms of vertigo appear when you make a sudden head movement, such as looking upward, rolling over in bed, lying flat, sitting up in bed or getting out of bed.

These everyday body movements, though, are not the causes.

Causes of BPPV

This form of vertigo happens when naturally existing crystal otoliths (calcium carbonate crystals) in the ear become dislodged and trapped in the inner ear’s semicircular canals. We don’t always know what causes the movement of the calcium carbonate, but several reasons for it can include:

• Trauma to the head, neck or ear
• A virus or other ear infection
• High-intensity workouts, such as mountain biking or aerobics
• Aging
• Dehydration

Benign paroxysmal positional vertigo symptoms

The overriding symptom of BPPV is brief vertigo lasting only a few seconds to minute. When you experience vertigo, the room will most likely feel like it’s spinning, but you can also have:

• Dizziness
• Difficulty focusing the eyes
• Balance issues or falling

Besides vertigo, other symptoms of BPPV may include:

• The feeling of confusion or brain fog
• Lightheadedness between vertigo spells

Benign paroxysmal positional vertigo treatments

BPPV is typically treated using a series of vestibular physical therapy exercises referred to as the Epley maneuver. Sometimes a combination of treatments, including medication and surgical techniques, might be used for more persistent cases.

Epley maneuver for BPPV

A doctor or a physical therapist performs the Epley maneuver by putting your body into various positions to move the displaced otoliths. These highly effective head and body movements take about five minutes to complete and often deliver immediate results. However, in some cases, it can take 24 to 72 hours for symptoms to stop. If you have a relapse, you can be successfully treated again. There is relatively little risk to this gentle body manipulation procedure.

Other BPPV treatment options

While the Epley maneuver via physical therapy is the best treatment option for BPPV, we might use a combination of methods, including:

• Medications – Motion-sickness drugs can help relieve symptoms of vertigo, dizziness, and its associated nausea and vomiting.
• Surgery – In severe cases, doctors may recommend a minor surgical procedure to block the otoliths from entering the semicircular canals, although this is rarely used.

Your doctor or physical therapist can also teach you a series of exercises you can do at home if you suspect BPPV and vertigo may recur.