What is benign paroxysmal positional vertigo?

Vertigo is the feeling that you are spinning or the world is spinning around you. Benign paroxysmal positional vertigo is a balance problem that causes brief vertigo spells that come and go.

For many people, BPPV goes away by itself in a few weeks, but treatment can help. It can come back again.

BPPV isn't a sign of a serious health problem.

The main symptom of BPPV is the feeling that you or your surroundings are spinning, whirling, or tilting. This sensation is called vertigo. It usually lasts less than a minute.

It's important to understand the difference between vertigo and dizziness. People often use those two terms as if they meant the same thing. But they are different symptoms, and they may point to different problems.

• Vertigo is the feeling that you are spinning or the world is spinning around you. It happens when your body's balance sensory systems disagree about what kind of movement they sense. You may find it hard to walk or stand. You may even lose your balance and fall. If your vertigo is bad enough, you may also have nausea and vomiting.
• Dizziness isn't a feeling that you are spinning. It is a woozy or unsteady feeling.

BPPV is diagnosed with a physical exam. Your doctor will ask questions about your symptoms and past health.

A Dix-Hallpike test may be done to help your doctor find out the cause of your vertigo. During this test, the doctor watches your eyes while turning your head and helping you lie back. This will help your doctor know whether the cause of your vertigo is inside your brain, your inner ear, or the nerve connected to your inner ear. This test also can help your doctor find out which ear is affected.

BPPV may go away in a few weeks by itself. If treatment is needed, it usually involves your doctor moving your head in different directions. Examples are Epley and Semont maneuvers. These movements will move the particles out of the semicircular canals of your inner ear.

Over time, your brain may react less and less to the confusing signals triggered by the particles in the inner ear. This is called compensation. It occurs fastest if you keep doing normal head movements, even if those movements cause the whirling feeling of vertigo.

A Brandt-Daroff exercise may also be done. It can speed the compensation process.

In rare cases, surgery may be used to treat BPPV.

Vertigo causes loss of balance and puts you at risk for falling. Be extra careful so that you don't hurt yourself or someone else if you have a sudden attack of vertigo.

• Don't drive or ride a bike if you are having vertigo.
• Keep floors and walkways free of clutter so you don't trip.
• Avoid heights.

Your doctor may suggest that you do the Epley maneuver at home. Here's how:

• Sit on the edge of a bed. Turn your head halfway between looking straight ahead and looking to the side that causes the worst vertigo (45 degrees).
• Tilt yourself backward until you are lying on your back. Your head should stay at the 45-degree turn. Hold for 30 seconds. If you have vertigo, stay in this position until it stops.
• Turn your head all the way to the other side without lifting it. Your chin should be raised and over your shoulder. Hold for 30 seconds or until your symptoms stop.
• Keeping your head in the same position, roll your body the same direction you are facing. You should now be on your side and looking down. Hold for 30 seconds or until your symptoms stop.
• Slowly push yourself up to a sitting position.