What Is BPPV? Causes, Symptoms, and Treatment for Positional Vertigo

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If you have ever rolled over in bed or looked upward and suddenly felt like the room was spinning, you may have experienced BPPV.

Benign Paroxysmal Positional Vertigo (BPPV) is one of the most common causes of dizziness and vertigo seen by ENT specialists. Although the symptoms can feel alarming, BPPV is usually treatable.

At SCENT Houston, Dr. Madeleine S. Herman evaluates patients with dizziness, vertigo, ear disorders, and balance problems to help identify the cause and provide effective treatment.

What Is BPPV?

BPPV stands for:

• Benign = not dangerous

• Paroxysmal = sudden episodes

• Positional = triggered by changes in head position

• Vertigo = spinning sensation

BPPV occurs when tiny calcium crystals inside the inner ear become displaced and move into the wrong part of the balance system.

These crystals interfere with normal balance signals, causing brief episodes of spinning dizziness when the head moves.

What Causes BPPV?

In many patients, BPPV occurs without a clear reason. However, it may be associated with:

• Aging

• Head injury

• Viral inner ear infections

• Prolonged bed rest

• Previous ear disorders

BPPV becomes more common as we get older.

Symptoms of BPPV

The hallmark symptom is brief episodes of spinning vertigo triggered by movement.

Common triggers include:

• Rolling over in bed

• Looking up

• Bending down

• Rapid head movements

Symptoms may include:

• Spinning sensation

• Dizziness

• Nausea

• Imbalance

• Motion sensitivity

Episodes are typically brief, often lasting less than one minute, but can recur repeatedly.

What Does BPPV Feel Like?

Many patients describe:

• “The room suddenly spins.”

• “I feel dizzy when I turn over in bed.”

• “I get vertigo when I look upward.”

• “I feel off balance after the spinning stops.”

Even though BPPV is not usually dangerous, it can significantly affect quality of life and increase fall risk.

How Is BPPV Diagnosed?

ENT specialists diagnose BPPV based on:

• Your symptoms

• Physical examination

• Positional testing

A common test called the Dix-Hallpike maneuver helps identify which ear and balance canal are involved.

During testing, your doctor watches for abnormal eye movements called nystagmus, which are characteristic of BPPV.

How Is BPPV Treated?

The Epley Maneuver

The most common treatment for BPPV is the Epley maneuver, a series of guided head movements designed to reposition the displaced crystals.

This treatment:

• Is performed in the office

• Usually takes only a few minutes

• Can provide rapid relief

• Often improves symptoms immediately

Some patients may require repeated treatments.

Vestibular Therapy for BPPV

Patients with persistent dizziness or imbalance may benefit from vestibular physical therapy.

Vestibular therapy can help:

• Improve balance

• Reduce motion sensitivity

• Retrain the brain’s balance system

  
  

Can BPPV Come Back?

Yes. Recurrence is common, even after successful treatment.

Some patients experience occasional episodes over time, but many respond well to repeat repositioning maneuvers.

When Should You See an ENT for Vertigo?

You should seek medical evaluation if you experience:

• Severe dizziness

• Recurrent vertigo

• Hearing loss

• Ear fullness

• Ringing in the ears

• Difficulty walking

• Neurologic symptoms such as weakness or double vision

Not all dizziness is caused by BPPV, so proper evaluation is important.

Vertigo and BPPV Treatment in Houston

At SCENT Houston, we evaluate and treat:

• BPPV

• Vertigo

• Dizziness

• Balance disorders

• Ear-related causes of dizziness

• Tinnitus and hearing loss

  
  

Dr. Madeleine Herman provides comprehensive ENT care for patients experiencing dizziness and balance symptoms.

If you are struggling with spinning dizziness or positional vertigo, schedule an evaluation with our Houston ENT team today.