What is benign paroxysmal positional vertigo?

Vertigo is the sudden sensation that you are unsteady or that your surroundings are moving. Benign paroxysmal positional vertigo (also called BPPV) is the most common kind of vertigo.

BPPV is an inner ear problem that causes you to suddenly feel dizzy when you move your head in a certain direction, lie down from an upright position, turn over in bed, or sit up in the morning.Moving your head to look up can also make you feel dizzy.

Although BPPV can be bothersome, it is rarely a serious problem. Episodes of BPPV are usually short, lasting less than a minute, and the problem tends to come and go. In some cases, BPPV goes away by itself with little or no treatment.

What causes BPPV?

Your inner ear contains tiny calcium particles that help you keep your balance. Normally, these particles are distributed evenly in the inner ear's three canals. When you move your head, the calcium particles stimulate nerve cells inside the canals. These cells send your brain a signal telling it what direction your head is moving.

However, these calcium particles can break loose and clump together in one of the ear's canals. When this happens, the nerve cells tell your brain that your head has moved more than it actually has. This incorrect signal results in vertigo. In most cases, BPPV is something that happens as part of aging. It can also occur after a blow to your head or, less often, as a result of a virus that infects your ear.

How does my clinician know I have BPPV?

Your clinician may suspect BPPV if you feel dizzy when you move your head certain ways. Your clinician will do a physical exam, ask you some questions, and review your medical history. If there is doubt about what is causing your dizziness, your clinician may order one or more tests to rule out more serious problems.

What can I do to cope with BPPV symptoms?

•      Get out of bed slowly. Sit on the edge of the bed for a minute before standing up

•      Be careful when you bend to pick something up or when you raise your head back to get something from an upper cabinet. Make these movements slowly

•      Sit or lie down right away whenever you feel dizzy

•      Be careful when getting up from lying back at the dentist's office, beauty parlor or barbershop, or during activities such as yoga or massage

How is BPPV treated?

Your clinician may recommend some simple head movements that you can do at home. These movements, called the Brandt-Daroff exercise, can help move the calcium particles in the canals in your inner ear. This easy exercise can stop the symptoms and may keep the dizziness from coming back.

How to Do the Brandt-Daroff Exercise

1.   Sit on the edge of a bed or sofa with your legs hanging over the side. Sit near the middle so that you can lie down in either direction

2.    Quickly lie down onto your right side, resting your right ear on the bed or sofa, looking straight ahead. Hold this position for 30 seconds (or until any dizziness passes, whichever is longer)

3.   Return to the up right position and look straight ahead. Hold this position for 30 seconds

4.    Quickly lie down onto your left side, resting your left ear on the bed or sofa, looking straight ahead. Hold the position for 30 seconds or until any dizziness passes

5.   Return to the upright position and look straight ahead for 30 seconds

These steps make up one 'set' of the Brandt-Daroff exercise. Do 5 repetitions of this set.It should take about 10 minutes.

 Try to do 2 or 3 exercise sessions a day for 10 days to 2 weeks. You can do one exercise session in the morning, another at lunchtime, and/or one before you go to bed. If your symptoms go away after one week of doing these exercises, you can cut back to 2 repetitions 3 or 4 times a week for the next week.

This document is intended to provide health related information so that you may be better informed. It is not a substitute for your care team's medical advice and should not be relied upon for treatment for specific medical conditions.

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