BPPV stands for benign paroxysmal positional vertigo. It is a very common cause of vertigo. The name sounds alarming, but each word is simple:
- Benign: it is not dangerous in itself.
- Paroxysmal: it comes in sudden, short bursts.
- Positional: it is set off by moving your head into certain positions.
What it feels like
- A sudden, strong spin when you move your head in a particular way: lying down, rolling over in bed, sitting up, looking up at a shelf, or bending down.
- Each spin is short, usually less than a minute, even though it can feel much longer.
- Nausea is common. You may feel unsteady for a while afterwards.
- Hearing is not normally affected.
What causes it
Inside the inner ear there are tiny crystals that normally sit in one part of the balance organ. In BPPV, some of them come loose and drift into one of the fluid-filled canals that sense head turning. When you move your head, the crystals move too, and the canal sends a false "spinning" signal.
It can follow a knock to the head or an inner ear illness, and it becomes more common with age, but often there is no clear reason.
How it is diagnosed
A doctor or vestibular physiotherapist usually moves your head into specific positions and watches your eyes for nystagmus (jerky eye movements). A common test is the Dix-Hallpike test. Which canal and which side is affected decides the treatment.
How it is treated
BPPV is often treated with repositioning manoeuvres, a set of head and body movements that guide the crystals back to where they belong. Examples include the Epley and Semont manoeuvres for the back canal and the BBQ roll for the side canal. Many people improve after one or a few sessions. It can come back, and the same manoeuvres usually help again.
BPPV in VertigoMe
- When you log a spin, the Symptoms step has a section called Position when it started, with options such as Rolling over in bed, Looking up and Sitting up or standing up. Over time this shows which movements set you off.
- The Exercises row on Home (Premium) includes guided Epley, Semont and BBQ roll manoeuvres and Brandt-Daroff exercises. Your phone coaches the angles. Please only do repositioning manoeuvres your clinician has recommended, for the side and canal they have confirmed. If you have neck or back problems, ask first.
When it might not be BPPV
Positional dizziness can have other causes. See a doctor if your spins last longer than a minute or two, if they come without any head movement, if you have hearing loss, a new headache, or any numbness, weakness, double vision or trouble speaking.
This is general information only. It cannot tell you what is causing your symptoms. Please speak to your GP, ENT, neurologist or audiologist about your own situation.
