Help and frequently asked questions

What is Benign paroxysmal positional vertigo (BPPV)?


BPPV causes short episodes of intense dizziness (vertigo) when you move your head in certain directions, especially in older people. Vertigo is the sensation that you or your surroundings are moving. Benign paroxysmal positional vertigo is thought to be caused by tiny solid fragments (otoconia) in the inner ear labyrinth. In many cases the condition gets better on its own after several weeks. A simple treatment of moving the head into various positions over a few minutes can cure the condition in many cases. This treatment uses gravity to move the tiny fragments away from where they are causing problems.

- Benign means that it is due neither to a cancerous nor a serious cause. (The symptoms of BPPV may be unpleasant but the underlying cause is not serious.)

- Paroxysmal means recurring sudden episodes of symptoms.

- Positional means that the symptoms are triggered by certain positions. In the case of BPPV, it is certain positions of the head that trigger symptoms.

- Vertigo is dizziness with a sensation of movement. If you have vertigo you feel as if the world is moving around you or that you are moving when you aren't. You feel very unsteady, a bit like being on a ship. Often you will also feel sick (nauseated), although you will not usually be sick (vomit).

Most cases of BPPV occur in people over the age of 40. Therefore, it may be an age-related thing. BPPV is one of the most common causes of vertigo in older people. However, some younger people develop BPPV following an injury to the ear, or following a previous infection in the inner ear. Sometimes it occurs in younger people for no apparent reason. Women are affected about twice as often as men.

The main symptom is vertigo. The vertigo lasts just a short time - typically just for 20-30 seconds and usually no longer than a minute. It then goes away completely if you keep your head still. The vertigo is usually triggered by a change in head position. For example, getting out of bed and rolling over in bed are two of the most common movements that trigger a short episode of vertigo. Sometimes just looking up triggers an episode of vertigo.

With each episode of vertigo you may feel sick (nauseated) but it is not common to be sick (vomit). The nausea may last an hour or so even though the vertigo lasts just seconds.

Between episodes of BPPV you feel well. Many people who develop BPPV realise which head movements trigger their symptoms and so instinctively avoid doing those movements.

In most cases, the symptoms clear away within several weeks or months. The solid fragments (otoconia) may dissolve or float out from the posterior semicircular canal and lodge in the vestibule where they cause no symptoms. However, after the symptoms have gone, some people have recurrences of symptoms months or years later. In some cases, symptoms persist for years.