All of a sudden, feeling giddy or having a sensation of your body rotating? Is this not an unusual occurrence for you? If such situations recur frequently, it is possible that they are caused by benign paroxysmal positional vertigo. BPPV symptoms include giddiness, nausea, loss of balance. Benign paroxysmal positional vertigo treatment is based on utilization of repositioning manoeuvres (Epley manoeuvre), medications and surgical intervention, which is opted for extremely seldom. Below you can find more detailed information about the nature of this condition, as well as its diagnostic methods and treatment options available.

One of the most common causes of vertigo is known as benign paroxysmal positional vertigo (or BPPV). It is the sudden feeling of spinning or the inside of your head is spinning.

This conditions leads to short episodes of mild to intense dizziness. It is normally triggered by very specific changes in the position of your head. It can occur when:

  • Tip your head up or down
  • When you lie down
  • When you turn over or sit up in bed

benign paroxysmal positional vertigo; BPPV symptoms; Benign paroxysmal positional vertigo treatment; Epley manoeuvre


It is the result of a mechanical problem within the inner ear and occurs when some of the calcium carbonate crystals (otoconia) that are normally embedded in gel in the utricle become dislodged and move into one or more of the 3 fluid-filled semicircular canals, where they are not supposed to be.

These crystals interfere with the normal fluid movement when enough of these particles collect in one of the canals. As these canals are used to sense head motion, it will cause the inner ear to send false signals to the brain.

BPPV will not cause constant dizziness that is not affected by movement or a change in position. It will also not affect your hearing or cause you to faint, lead to headaches or other neurological symptoms such as numbness, the sensation of “pins and needles,” or difficulty speaking or coordinating your movements.

If you experience these additional symptoms, you must inform your doctor immediately. This is because other conditions may initially be misdiagnosed as BPPV. However, if you alert your doctor regarding the additional symptoms, they’ll be able to re-evaluate your diagnosis.


Signs and symptoms of benign paroxysmal positional vertigo (BPPV) may include:

  • Vomiting
  • Dizziness
  • Nausea
  • A sensation that you or your surroundings are spinning or moving (vertigo)
  • A loss of balance or unsteadiness

These symptoms may come and go, and they normally last for less than one minute. Episodes of BPPV can disappear for some time and reappear later on.



Your doctor may consider teaching you to use this simple method, which often works if you have fragments of debris (otoconia) at the bottom of your posterior semicircular canal—a common situation. It will require you to perform a series of four movements of the head, and after each movement, the head is held in the same position for about 30 seconds.

This maneuver causes the posterior semicircular canal in your head to rotate around in such a way that gravity moves the otoconia particles out from the posterior canal and into the vestibule, where they then settle and cause no symptoms.


Surgery is usually the least popular resourt because in most cases, BPPV-caused discomfort either resolves on its own or with the help of Epley Manoeuvre. But in rare cases, symptoms may persist for months to years with no relief. Then, a surgery on the inner ear to remove the function of the posterior semicircular canal may be an option, and an ear specialist will be able to advise


Physical examination

To determine the cause of your dizziness, a series of tests may be conducted. During these examinations, your doctor will look for:

  • Dizziness that’s triggered by eye or head movements that subsequently diminish within a minute
  • Dizziness linked to specific eye movements that occurs when you’re on your back with your head turned to the side and tipped slightly over the edge of the examination bed
  • Involuntary movements of your eyes from side to side (nystagmus)
  • Inability to control your eye movements

Electronystagmography (ENG) or videonystagmography (VNG)

Designs to detect abnormal eye movement. These tests will be used to determine whether the dizziness is the result of an inner disorder. ENG (which uses electrodes) or VNG (which uses small cameras) are used to measure involuntary eye movements while your head is placed in different positions or while your balance organs are stimulated with water or air.

Magnetic resonance imaging (MRI)

Magnetic field and radio waves are used to create cross-sectional images of your head and body. These images are used by your doctor to determine and diagnose a range of conditions. MRI may be performed to eliminate other possible causes of your vertigo.