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Benign positional vertigo is the most common type of vertigo. Vertigo is the feeling that you are spinning or that everything is spinning around you. It may occur when you move your head in a certain position.
Vertigo - positional; Benign paroxysmal positional vertigo; BPPV: dizziness- positional
Benign positional vertigo is also called benign paroxysmal positional vertigo (BPPV). It is caused by a problem in the inner ear.
The inner ear has fluid-filled tubes called semicircular canals. When you move, the fluid moves inside these tubes. The canals are very sensitive to any movement of the fluid. The sensation of the fluid moving in the tube tells your brain the position of your body. This helps you keep your balance.
BPPV occurs when a small piece of bone-like calcium breaks free and floats inside the tube. This sends confusing messages to your brain about your body's position.
BPPV has no major risk factors. However, your risk for developing BPPV may increase if you have:
BPPV symptoms include:
The spinning sensation:
Certain positions can trigger the spinning feeling:
To diagnose BPPV, your health care provider may perform a test called the Dix-Hallpike maneuver.
If the Dix-Hallpike test doesn't show a clear result, you may be asked to do other tests.
Your provider will do a physical exam and ask about your medical history. You may have brain and nervous system (neurological) tests to rule out other causes. These may include:
Your provider will do a procedure called Epley's maneuver. It can move the small piece of calcium that is floating inside your inner ear. This treatment works best to cure BPPV. Other exercises don't work as well.
Some medicines can help relieve spinning sensations.
However, these medicines often do not work well for treating vertigo.
To keep your symptoms from getting worse, avoid the positions that trigger it.
BPPV is uncomfortable, but it can usually be treated with Epley's maneuver. It may come back again without warning.
People with severe vertigo may get dehydrated due to frequent vomiting.
Call your health care provider if:
Get immediate medical help if you also have symptoms such as:
These may be signs of a more serious condition.
Avoid head positions that trigger positional vertigo.
Bhattacharyya N, Baugh RF, Orvidas L, Barrs D, Bronston LJ, Cass S, et al. Clinical practice guideline: Benign paroxysmal positional vertigo. Otolaryngology: Head & Neck Surgery. 2008; 139 (5 Suppl 4): S47-S81.
Crane BT, Schessel DA, Nedzelski J, Minor LB. Peripheral vestibular disorders. In: Cummings CW, Flint PW, Haughey BH, et al, eds. Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2010:chap 165.
Post RE, Dickerson LM. Dizziness: a diagnostic approach. Am Fam Physician. 2010;82:361-369.
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