Vertigo is a feeling of movement, including spinning. Benign paroxysmal positional vertigo (BPPV) happens when the position of the head is changed. This might include standing after bending down, turning the head in bed, or extending the neck to look up. People with BPPV can often identify which moves cause the most problems.

If you suspect you have this condition, contact your doctor.


The inner ear contains tiny crystals. These crystals can sense movement and help you keep your balance. BPPV occurs because of a shift in location of these crystals. When these crystals move to the wrong location or clump in one spot, BPPV can result.

Inner Ear

The clump of ear crystals can lead to BPPV.
© 2009 Nucleus Medical Art, Inc.

BPPV may be caused by:

  • Head injury
  • Viral infection, such as labyrinthitis]]> , an infection of the nerve to the ear
  • Disorders of the inner ear
  • Prolonged immobility of the head
  • Age-related changes to inner ear

Risk Factors

These factors increase your chance of BPPV. Tell your doctor if you have any of these risk factors:

  • Advancing age
  • Head injury
  • Prolonged immobility of head


If you have any of these symptoms do not assume it is due to BPPV. These symptoms may be caused by other conditions. Tell your doctor if you have any of these:

  • Sudden dizziness that lasts less than a minute
  • Feeling of spinning
  • Dizziness with certain movements
  • Loss of balance
  • Nausea
  • Vomiting
  • Feeling unsteady
  • Fatigue
  • Swaying


Your doctor will ask about your symptoms and medical history. A physical exam will be done. Your doctor will look for symptoms of dizziness as you move your head. Abnormal eye movements common to BPPV may be found. You may be referred to a doctor who specializes in treating ears (otolaryngologist).

Tests may include the following:

  • Electronystagmography (ENG)—test that uses electrodes to measure eye movements; used to evaluate inner ear disease
  • MRI scan]]> —test that uses magnetic waves to form a picture of body structures; used to look for other problems in the brain that may cause symptoms


Many times BPPV can resolve on its own, usually within months of onset. Talk with your doctor about the best treatment plan for you. Treatment options include the following:

Vestibular Exercises (Vestibular Rehabilitation)

Your doctor may suggest specific vestibular exercises. These exercises use a series of eye, head, and body movements to get the body used to moving without dizziness. You may work with a physical therapist to learn these.

Canalith Repositioning

This procedure is done in your doctor’s office. Your doctor will move your head in different positions to try and resettle the tiny crystals. The procedure is sometimes repeated and you may be taught how to do it at home.


Some people with BPPV undergo surgery. During surgery, a piece of wax may be used to plug one area of your ear. This will prevent fluid in your inner ear from moving. Another type of surgery that may be performed involves cutting the nerve from the inner ear.


There are no known guidelines for preventing BPPV.