Benign Paroxysmal Positional Vertigo

The world is spinning

Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo. It is also very treatable.

What does it stand for?

the cause of dizziness is not a threat to your health

dizziness comes in short bursts

dizziness is brought on by certain head/body positions

the medical name for the spinning sensation


The following are possible symptoms of BPPV;

  • Feeling like you are spinning or moving
  • Feeling like the world is spinning or moving
  • Loss of balance
  • Nausea
  • Vomiting


BPPV occurs when dense particles called otoconia (usually referred to as crystals or rocks), come loose from one part of the inner ear called the utricle and fall into another part of the ear (one of the semicircular canals).

When you make those movements described above (getting out of bed, rolling over in bed, tilting your head back or forwards), the otoconia move within the semicircular canal and send an incorrect message to your brain and eyes that you are spinning.

The most common reasons that the otoconia come loose include head injury (even mild), degeneration of the vestibular system or damage to the inner ear. Idiopathic BPPV is when no cause can be found.


This condition can be confirmed by observing nystagmus— jerky eye movements during positional testing such as the Dix-Hallpike. To ensure a correct diagnosis is made, we record eye movements using videonystagmography. The pattern of nystagmus confirms which semicircular canal is affected and if the otoconia are free floating or stuck. 

This is a video of someone with posterior canal BPPV


We treat all types of BPPV. The treatment will depend on the diagnoses. The most common diagnosis is posterior canalithiasis and the treatment is the Epley manoeuvre.