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Benign Paroxysmal Positional Vertigo

Benign paroxysmal positioning vertigo (BPPV) is a common type of vertigo. It is caused by inner ear crystals that drift into the back, bottom inner ear semicircular canal (otoconia in the posterior semicircular canal). Viral illness, head injury, stress, tiredness, aging, and other things seem to be correlated with BPPV.

The most typical movements that provoke vertigo are lying back into bed, getting up out of bed, tipping the head back (for example to instill eye drops), and bending over and standing up quickly.

The canalith repositioning maneuver (Epley maneuver) or the Semont's liberatory maneuver almost always resolve the problem. When these measures fail, a careful re-evaluation may reveal a different diagnosis. Commonly, BPPV is accompanied by other balance organ problems that improve with vestibular exercises.

When BPPV is unequivocally confirmed and no more serious cause has been ruled out, the rare patient may require surgery. Surgery for BPPV occludes the posterior semicircular canal, has low risk, and is highly effective.

Home Treatment Exercises for Treating BPPV

The maneuvers demonstrated in the links below are two of the ways to reposition the loose crystals so that the symptoms caused by the loose crystals go away. You may feel nauseas and have a floating - swaying sense while walking or sitting for a few days after these procedures.

Instructions after completing the the Canalith Repositioning (CRP) maneuver:

  • Keep chin straight forward to tipped down a bit.
  • Do not tip head back to drink water but use a straw.
  • Restrictions apply for the first 24 hours after the treatment. When reclining for sleep, sleep as near upright as possible. Ideally, the head should not tip backwards more than 30 degrees which means that the back cannot be tilted backwards more than 30 degrees.
  • There is no limit to how many times the CRP can be re-done.

If the repositioning maneuver does not seem to clear the problem, please allow us to evaluate you again. Rarely, a more serious problem may initially look like Benign Paroxysmal Positioning Vertigo (BPPV). As well, some patients simply have too much debris in the posterior semi-circular canal to clear without surgery. Surgery can also relieve BPPV, but surgery is only rarely necessary.