What Is Benign Positional Vertigo?
Benign positional vertigo (BPV) is the most common cause of
vertigo. It causes a sudden sensation of spinning. It can also make you feel
like your head is spinning from the inside.
If you have BPV, you can have brief periods of mild or intense
dizziness. An episode is generally triggered by changing the position of your
head. In particular, the following actions can trigger an episode of BPV:
- tilting your head up or down
- lying down
- turning over
- getting up
BPV can be annoying, but it’s rarely serious except when a person
falls due to dizziness.
What Causes Benign Positional Vertigo?
BPV is the result of a disturbance inside your inner ear. Fluid
inside tubes in your ear, called semicircular canals, moves when your position
changes. The semicircular canals are extremely sensitive.
BPV develops when small crystals of calcium carbonate that are
normally in another area of the ear break free and find their way to the
semicircular canal in your inner ear. This causes your brain to receive
confusing messages about your body’s position.
Who Is at Risk for Benign Positional Vertigo?
There are no major risk factors for BPV, but there’s some
indication that it could be an inherited condition. Many diagnosed individuals
have indicated that multiple relatives also have had the condition.
Prior head injuries, osteoporosis, diabetes, or an inner ear condition
can also make some people more prone in developing BPV.
What Are the Symptoms of Benign Positional Vertigo?
The symptoms of BPV can include:
- vertigo, which is a sensation of spinning or
- blurred vision
- loss of balance
Symptoms of BPV can come and go. They commonly last less than one
A variety of activities can bring on BPV. However, most symptoms occur
when there’s a change in your head’s positioning. Abnormal eye movements, also
called nystagmus, usually accompany BPV symptoms. Although it’s extremely rare,
you can have BPV in both ears.
In some extreme cases of BPV, people can develop dehydration due
How Is Benign Positional Vertigo Diagnosed?
Your doctor can diagnose BPV by performing a test called the
Dix-Hallpike maneuver. Your doctor will hold your head in a certain position
while asking you to rapidly lie down with your back over a table. They’ll look
for abnormal eye movements during this test, and they may ask you if you’re experiencing
a spinning sensation.
Your doctor will also give you a general physical exam. They’ll
get a complete medical history and perform a neurological exam to rule out any
other disorders or diseases.
Additional tests might include:
- caloric stimulation, which is a warming and
cooling the inner ear with water or air to observe eye movements
- magnetic resonance angiography of the head
- hearing evaluation
- MRI of the head
- CT scan of the head
- electronystagmography (ENG) to record eye
- electroencephalogram (EEG) to measure brain
What Are the Treatments for Benign Positional Vertigo?
Some doctors consider Epley’s maneuver to be the most effective
BPV treatment. It involves moving the piece of calcium carbonate to a different part of
your inner ear where it will no longer cause problems.
Your doctor may prescribe medications to relieve spinning
sensations. These drugs may include:
However, medications are often not effective in treating vertigo.
There are steps you can take to manage the dizziness associated
Losing your balance is always a possibility. Be aware of your
surroundings and avoid placing yourself at risk. Falls can cause serious
Whenever you feel dizzy, take a seat. Sitting down during a dizzy
spell can help you avoid falling. You should also take precautions such as using good lighting
around the home and using a cane for stability.
Also, learn what triggers
your episodes. Preventing symptoms of vertigo from becoming worse during
episodes of BPV can be as simple as avoiding the positions that trigger it.
What Are the Complications of Benign Positional Vertigo?
It may be necessary to call your doctor if the treatment for
vertigo isn’t working or if you develop weakness, slurred speech, or vision
Keep in mind that symptoms of BPV can sometimes be related to
other, more serious conditions.
What Is the Long-Term Outlook?
Living with the condition can be challenging. It can affect
relationships with friends and family, productivity at work, and quality of
life. BPV is uncomfortable but manageable, and it usually improves with time.
Unfortunately, BPV can occur again after successful treatment, and it may return
without warning. There’s no cure for BPV.