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Benign Paroxysmal Positional Vertigo

Benign paroxysmal positional vertigo (BPPV) is a common condition. You feel as if the room is spinning after changing position, moving your head quickly, or even just rolling over in bed.

Vertigo is a false feeling of motion plus disorientation that makes it seem as if the room is spinning. A vertigo attack may cause sudden nausea, vomiting, and heavy sweating. Severe vertigo causes a loss of balance. You may even fall down.

Vertigo is caused by a problem with the inner ear. The inner ear is located behind the middle ear. It is a part of the balance center of the body. It contains small calcium particles within fluid-filled canals (semicircular canals). These particles can move out of position. This may happen as a result of aging, head injury, or disease of the inner ear. Once that happens, moving your head in certain ways may cause the particles to stimulate the inner ear. This creates the feeling of vertigo.

An episode of vertigo may last seconds, minutes, or hours. Once you are over the first episode of vertigo, it may never return. Sometimes symptoms return off and on for several weeks or longer.

BPPV is treatable. The Epley maneuver is a simple treatment for the common cause of vertigo. Your provider may try to put the calcium particles back in their correct position by having you do a series of head movements. Your provider may have you do other types of maneuvers, depending on which canals the crystals are in.

Home care

Follow these guidelines when caring for yourself at home:

  • Rest quietly in bed if your symptoms are severe. Change position slowly. There is usually 1 position that will feel best. This might be lying on one side or lying on your back with your head slightly raised on pillows. Until you have no symptoms, you are at a higher risk of falling. Let someone help you when you get up. Get rid of home hazards such as loose electrical cords and throw rugs. Don’t walk in unfamiliar areas that aren't lighted. Use night-lights in bathrooms and kitchen areas.

  • Don't drive or work with dangerous machinery for 1 week after symptoms go away. This is in case symptoms return suddenly.

  • Take medicine as prescribed to relieve your symptoms. Unless another medicine was prescribed for nausea, vomiting, and vertigo, you may use over-the-counter motion sickness medicine. Examples of this include meclizine and dimenhydrinate. Don't take over-the-counter medicine for this condition without talking with your healthcare provider, especially the first time.

Follow-up care

Follow up with your healthcare provider or an ear, nose, and throat specialist (ENT or otolaryngologist), or as directed. Tell your provider about any ringing in your ear or hearing loss.

If you had a CT or MRI scan, a specialist will review it. You'll be told of any new findings that may affect your care.

When to get medical advice

Call your healthcare provider right away if any of these occur:

  • Vertigo gets worse even after taking prescribed medicine

  • Repeated vomiting even after taking prescribed medicine

  • Weakness that gets worse

  • Trouble hearing

  • Fever of 100.4ºF (38ºC) or higher, or as directed by your healthcare provider

Call 911

Call 911 right away if any of these occur:

  • Fainting

  • Severe headache or abnormal drowsiness or confusion

  • Weakness of an arm or leg or one side of the face

  • Trouble with speech or vision

  • Trouble walking

  • Seizure

  • Fast heart rate

  • Chest pain

Online Medical Reviewer: Ashutosh Kacker MD
Online Medical Reviewer: Rita Sather RN
Online Medical Reviewer: Tara Novick BSN MSN
Date Last Reviewed: 12/1/2022
© 2000-2023 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
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