Benign Paroxysmal Positional Vertigo BPPV

The experts believe that about 20% of the dizziness is caused due to loose crystals in the inner ear. Due to crystal disorder, we can lose our hearing power. Also called as positional vertigo, BPPV is a form of balance disturbance that originates in the inner ear. It is a sensation of spinning that occurs when getting out of bed or turning your head too quickly. The dislocated crystals cause abnormal stimulation of the nerve receptors when the head is moved in certain ways. This abnormal stimulation results in the perception of vertigo, or spinning.

If you need any assistance or have a question about Benign Paroxysmal Positional Vertigo (BPPV), you can consult our HearingSol experts with your problem, feel free to call us on +91-9327901950. We are always here to help you.

Benign Paroxysmal Positional Vertigo (BPPV) is one of the types of Vertigo (a sensation of spinning).

  • Benign – it is not life-threatening
  • Paroxysmal – it starts unexpectedly and lasts for a short period
  • Positional – it is triggered by certain postures or head movement
  • Vertigo – a sensation of spinning or dizziness

What Is BPPV?

When one or extra of the three semicircular canals can be displaced otoconia, then sufficient of them amass in a single spot, can disrupt the regular drift of fluid. The disruption of it reasons the maximum not unusual vertigo circumstance, Benign Paroxysmal Positional Vertigo—or BPPV.

The conventional sign of BPPV is the motion of episodic severe vertigo associated with modifications in head position, the general public can sense it on the time of dozing.

How Is BPPV Caused?

Otoconia crystals, one of the main components that affect how our balance behaves, moves according to the movement of our head. Sometimes these crystals dislocate from their normal spot in your ear and moves to different regions due to a variety of reasons. They can move into the canals of your ears, which senses your head’s rotation, especially when you are lying down. This causes the canal to become sensitive to the head movement to which it does not respond usually. This makes you feel dizzy. And this is how a BPPV causes.

How these crystal turn out to be free?

Before some time it can be unknown that something taking place like this. Yet now it may be recognized it’s far the result of head injury. Mountain cycling, excessive depth riding can cause of the BPPV. But BPPV is also like a deadly disease that may be affected to the inner ear. It may be positioned with the migraines.

Otoconia Crystals

Other causes:

  • High-intensity Aerobics
  • Meniere’s disease(an inner ear disorder)
  • Bed rest for a long time
  • Same position or no head movement for a long time(if at the dentist’s office or the hairdresser)
  • A certain type of migraine

Risk factors

  • Most often occurs in people aged 50 or older, but can occur at any age.
  • More common in women than in men.
  • Any head injury or other disorder of the balance organs of your ear.

Symptoms of BPPV

You should consult a doctor if you experience any of the following symptoms-

  • Spinning sensations
  • Feeling unstable or that you are losing your balance
  • Nausea or vomiting
  • Severe sense of disorientation in space
  • Loss of consciousness
  • Trouble speaking
  • Hearing loss
  • Fever
  • Double vision or loss of vision
  • Unusual or repetitive eye movements

How Long Does BPPV Last?

The BPPV is often recurrent which lasts for a few minutes. If not treated, it can last for about a week. However, there is always a chance of recurrence in the future. So you must be aware of the signs and symptoms. The trigger factors are unknown and the occurrence is unpredictable, which makes the BPPV condition more difficult.

How BPPV Can Be Recognized?

It is uncommon to diagnose to see the patients. To diagnose the BPPV Normal clinical imaging (e.G. An MRI) isn’t always powerful. Because in our ordinary eyes we can not see the movement of crystal in the semicircular canal however when man or woman can pass their head into any route then the crystal also moved into that function. When we flow our head in any direction than the eyes also circulate in a way that is referred to as “nystagmus”.

There is a courting among eyes muscle and internal ear which can make the recognition to our eyes at the surroundings. Eye movement can make us feel that some motion may take place into the internal ear canals however it shouldn’t appear.

There could be the special characteristics of the nystagmus that permit to diagnosed which ear has displaced crystal and in which it can pass.

Tests For BPPV

Dix-Hallpike Test

Dix-Hallpike Test

Doctors use the Dix-Hallpike Test(Dix-Hallpike maneuver) to check for a Benign paroxysmal positional vertigo. Your doctor will turn your head 45 degrees to one side. Your head needs to be off the edge of the table. The doctor will ask you to maintain this position for about 30 seconds. He will check your eyes for any new movement and ask you if you are feeling dizziness. The same procedure is repeated on another side.

Supine Roll Test

Supine Roll Test

If the Dix-Hallpike test is negative then the patient is also tested for lateral canal BPPV using Supine Roll Test. Lateral Canal (also called Horizontal canal) BPPV is the second common type of BPPV. In this test, a doctor provocate nystagmus and monitors the eye movement. Steps include-

  1. The patient is told to be positioned in supine with the head lying at the edge of the table.
  2. The doctor quickly rotates the head of the patient at 90 degrees at one side and notice the movement of the eyes.
  3. After this, the head is returned to normal position, and eyes are again inspected for nystagmus.

Treatment of BPPV

Canalith repositioning

It is performed at a doctor’s office but you can do it at home also after learning about the procedure from the doctor. It involves several maneuvers for positioning your head. The purpose is to move particles from fluid-filled canal of your inner ear to tiny bag like opening(vestibule) which consists of one of the otolith organs in your ear. These particles do not cause trouble and are more easily absorbed. Every position is held for about 30 seconds after any symptoms and new and different eye movement stops.


When the Canalith repositioning procedure does not provide effective results, a surgical method is recommended by a doctor. In a Surgical procedure, a bone plug is used to block the section of your ear that is causing dizziness. This plug prevents the canal of your ear to be able to respond to any particular head movement. There is a 90% chance of success of the surgery.

Home Remedies For BPPV

Epley Manoeuvre-

You need to follow the below-mentioned steps for vertigo in left ear issue:

  • Sit and turn your head at 45 degrees. Place the pillow such that on lying down, it rests between the shoulder and not under the head.
  • Lie down on a bed with a head still at 45 degrees. Your head should be placed on the bed, not the pillow. Wait for 30 seconds.
  • Turn your head about 90 degrees to the right. Wait for 30 seconds.
  • Now turn your head and body facing the floor and again wait for 30 seconds.
  • Sit up and wait for a few minutes.
  • This exercise should be done 3 times before going to bed until the symptoms improve.

Semont Manoeuvre-

Following steps are involved in it:

  • Turn your head at 45 degrees to the right after sitting by the edge of a bed.
  • Lie down on the left side and hold the position for 30 seconds.
  • Maintain the position of your head and quickly lie down on the opposite side. Hold the position of your head for 30 seconds then look at the floor.
  • Now sit up and wait for a few seconds.
  • This exercise should also be done for 3 times until the symptoms improve.

Brandt-Daroff Exercise-

  • Sit in a vertical position on a bed.
  • Turn your head at 45 degrees away from the side of vertigo. Now lie down on one side with your nose pointed up.
  • Hold this position for 30 seconds and return back to seated position.
  • Repeat the procedure for another side.
  • Do 3 sets of these movements in a day, each set having 3 to 5-time movements.

Steps you should take if suddenly experience BPPV-

  • Sit down immediately if you feel dizzy.
  • Use good lighting if you get up at night.
  • Be aware of the possibility of losing balance.

Results after treatment

After three to four treatments it can be 90% clear up, as a result. It cannot effortlessly get better to solve immediately. Your therapist can accurate it at one time if you have one or greater canals. For perfect results, it will likely be vital that you observe your vestibular therapist commands.


BPPV is a common condition and increases as age increases. It can range from mild to high annoyance which can affect the safety and your balancing coordination. But applying above mentioned exercises and consulting a doctor, the effect of BPPV can be reduced.

If you need any assistance or have a question about Benign Paroxysmal Positional Vertigo (BPPV), you can consult our HearingSol experts with your problem, feel free to call us on +91-9327901950. We are always here to help you.

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