BPPV – Benign Paroxysmal Positional Vertigo

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What is BPPV?

Benign Paroxysmal Positional Vertigo (BPPV) is a common cause of dizziness.

• It is benign because the condition is not harmful though the symptoms can be distressing
• It is paroxysmal because it can occur suddenly
• It is positional because the dizziness mostly occurs when the head is moved into the certain positions, most commonly when looking up, bending down, lying down and rolling over in bed
• It is called vertigo because there is a brief, but often intense, illusion of movement

What causes BPPV?

The balance part of your inner ear (vestibular system) has five parts to it. There are three tubes, each lying at a different angle, called the semicircular canals. There are also two patches of jelly that have little chalk crystals stuck to the surface. If these crystals come loose and float into one or more of the semi-circular canals it results in BPPV.

BPPV is thought to be caused by small fragments of debris (calcium carbonate crystals), which break off from the lining of the channels in your inner ear. The fragments don’t usually cause a problem unless they get into one of the ear’s fluid-filled canals. When your head is still, the fragments sit at the bottom of the canal. However, certain head movements cause them to be swept along the fluid-filled canal, setting off abnormal fluid movements. This sends confusing messages to your brain, causing vertigo.

What can be done?

In many people this condition will eventually get better by itself as the particles float back to where they came from. However, there is a manoeuvre that can help reposition the crystals. All it involves is moving the head slowly through a series of positions. While the manoeuvre does appear to be very successful in treating this condition, it sometimes needs to be performed more than once and does not work on everyone.

It is not uncommon to feel a little unsteady and fatigued after the treatment but this should settle within a couple of days. For this reason you may wish to be accompanied when you attend an appointment for this manoeuvre and we do not recommend you drive immediately after.

Post-treatment

To increase the chances of the particles settling in the correct place, it would be helpful if, for 48 hours after, you could:

• Avoid sleeping on the treated side
• Avoid lying completely flat
• Avoid any big up/ down head movements

Where can I get further information?

Who can I contact with any concerns or questions?

If you have any problems or are worried, please do not hesitate to contact us in the Ear, Nose and Throat Outpatient Department.