Benign Paroxysmal Positional Vertigo

Benign paroxysmal positional vertigo (BPPV) is one of the most common disorders of the vestibular system (inner ear). It is a problem that causes short periods of dizziness when your head is moved in certain positions. Symptoms occur most commonly when lying down, turning over in bed, getting out of bed, bending forward, or looking overhead. Symptoms of dizziness often include a sensation of spinning (vertigo) that lasts only a few seconds up to a minute. A person may also feel lightheaded, off balance and nauseated. 

BPPV is thought to be caused by small particles (calcium carbonate crystals) that have been displaced from another part of the inner ear into one of the small semicircular canals. These crystals are called otoconia, which are supposed to be attached to a membrane in a part of the inner ear called the utricle. In BPPV, the particles become loose, and migrate into one of the semicircular canals, often at night when you are sleeping. When you move your head in a certain way, the crystals move within the canal and stimulate the nerve endings, causing you to feel dizzy. Sometimes this condition can be caused by head trauma or an inner ear infection, but most commonly occurs spontaneously as a part of aging.

BPPV is very responsive to treatment, and 80-90% of patients can experience complete resolution of symptoms within one to two treatment sessions. Most patients recover from BPPV with a simple head /neck maneuver performed by the physical therapist, designed to move the crystals from the canal back into the area where they came from (the utricle). The most common maneuver is the Epley maneuver. Other maneuvers may be needed, depending on which semicircular canal is involved. Your therapist will evaluate you to determine which maneuver is indicated. If necessary, patients may be taught self management techniques to use at home to facilitate full recovery, and some patients may need to perform a specific exercise for one to two weeks following the first few treatments, if lingering symptoms persist. 


For more information, please contact the St. Alexius Human Performance Center at 701-530-8100 or 1-800-222-7858. Use Ask St. Alexius if you have a specific question concerning benign paroxysmal positional vertigo. Your answer will come in the form of an email.