What Triggers BPPV?

Reviewed on 3/19/2021
Benign positional paroxysmal vertigo (BPPV) is a disorder that makes you feel like your head is spinning.

Benign positional paroxysmal vertigo is a disorder that makes you feel like your head is spinning.

Benign positional paroxysmal vertigo (BPPV) is a disorder that makes you feel like your head is spinning. It is most commonly triggered by a change in positions or staying in a position for a long time. Examples include:

  • Tipping your head up or down
  • Lying down
  • Turning over in bed
  • Getting up from bed
  • Sitting in a dentist’s chair for a long time
  • Riding on a bike on rough roads
  • High-intensity exercises
  • Conditions of the ear such as infections

What causes BPPV?

Often, doctors do not know what causes benign positional paroxysmal vertigo (BPPV). This is called idiopathic BPPV.

BPPV is often associated with a minor to severe blow to your head. Less common causes of BPPV include:

  • Damage to your inner ear (such as that occurs during an ear surgery)
  • Migraines
  • Formation or deposits of calcium dislodging the semicircular canal of your ear, thus making your ear sensitive to head movements and making you feel dizzy

BPPV occurs most often in people who are 50 years of age and older but can occur at any age. It is also more common in women than in men.

What are the signs and symptoms of BPPV?

The signs and symptoms of benign positional paroxysmal vertigo (BPPV) may include one or more of the following symptoms:

You may or may not experience nausea and vomiting. Abnormal rhythmic eye movements are also seen.

You may experience the signs and symptoms of BPPV for a minute. However, they (BPPV attacks) keep recurring.

BPPV attacks can make you unsteady, causing you to fall and get injured.

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How is BPPV diagnosed?

Doctors usually diagnose benign positional paroxysmal vertigo (BPPV) by taking your medical history and looking at your signs and symptoms. They turn your head to one side and perform some tests (Epley maneuver) to diagnose the condition. Once they see positive responses (specific eye movements), they do not perform imaging tests such as magnetic resonance imaging (MRI) or computed tomography (CT) scans. They may perform these tests if you have additional symptoms (not typical of BPPV) and they want to rule out other causes of dizziness.

The first attack of BPPV is usually frightening because you feel as if you are getting a stroke. The doctor’s diagnosis of a less serious condition, BPPV, can be reassuring to you.

How is BPPV treated?

Benign positional paroxysmal vertigo (BPPV) is usually a self-limiting condition that disappears within a few days or months. Your doctor may initially prescribe any of the medicines known as vestibular suppressants. These can mask the symptoms of BPPV but do not cause it to go away entirely. Examples of the medications include meclizine, dimenhydrinate, droperidol, prochlorperazine, diazepam, lorazepam, alprazolam, and scopolamine.

If you want to get rid of BPPV completely and sooner, your doctor or a physical therapist may perform a procedure known as canalith repositioning and teach you how to do the same at home. The procedure, which is a series of movements, helps push the calcium liths from the semicircular canals back to their normal place in the ear.

If the canalith repositioning procedure does not work in relieving your BPPV, your doctor may recommend surgery on your ear known as ear canal plugging surgery.

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References
Benign Paroxysmal Positional Vertigo. https://emedicine.medscape.com/article/884261-overview

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