Ailmemts & Remedies

Benign paroxysmal positional vertigo (BPPV)

Common Name: BPPV

Benign paroxysmal positional vertigo (BPPV) is one of the most common causes of vertigo — the sudden sensation that some one spinning or that the inside of head is spinning.

BPPV causes brief episodes of mild to intense dizziness. It is usually triggered by specific changes in one’s head position. This might occur when he or she tips head up or down, when lie down, or when turn over or sit up in bed.

Although BPPV can be bothersome, it’s rarely serious except when it increases the chance of falls. One can receive effective treatment for BPPV during a doctor’s office visit.

BPPV can affect people of all ages but is most common in people over the age of 60.
Most patients can be effectively treated with physical therapy. In rare cases, the symptoms can last for years.


People with BPPV can experience a spinning sensation — vertigo — any time there is a change in the position of the head.

The symptoms can be very distressing. People can fall out of bed or lose their balance when they get up from bed and try to walk. If they tilt their head back or forward while walking, they may even fall, risking injury. Vertigo can cause the person to feel quite ill with nausea and vomiting tendensis.

While the hallmark of BPPV is vertigo associated with changes in head position, many people with BPPV also feel a mild degree of unsteadiness in between their recurrent attacks of positional vertigo.

The onset of BPPV may be abrupt and frightening. People may think they are seriously ill; for example, they may fear they are having a stroke. A doctor’s diagnosis of BPPV can be reassuring, especially when people understand that help is available to relieve their symptoms.

Without treatment, the usual course of the illness is lessening of symptoms over a period of days to weeks, and sometimes there is spontaneous resolution of the condition. In rare cases, the person’s symptoms can last for years.

In many people, especially older adults, there is no specific event that causes BPPV to occur, but there are some things that may bring on an attack:

*Mild to severe head trauma

*Keeping the head in the same position for a long time, such as in the dentist chair, at the beauty salon or during strict bed rest

*Bike riding on rough trails

*High intensity aerobics

*Other inner ear disease (ischemic, inflammatory, infectious)

BPPV occurs when tiny calcium crystals called otoconia come loose from their normal location on the utricle, a sensory organ in the inner ear.

If the crystals become detached, they can flow freely in the fluid-filled spaces of the inner ear, including the semicircular canals (SCC) that sense the rotation of the head. Otoconia will occasionally drift into one of the SCCs, usually the posterior SCC given its orientation relative to gravity at the lowest part of the inner ear.

The otoconia will not cause a problem when located in an SCC until the person’s head changes position, such as when looking up or down, going from lying to seated or lying to seated in bed, or when rolling over in bed. The otoconia move to the lowest part of the canal, which causes the fluid to flow within the SCC, stimulating the balance (eighth cranial) nerve and causing vertigo and jumping eyes (nystagmus).

Risk factors:
Benign paroxysmal positional vertigo occurs most often in people age 60 and older, but can occur at any age. BPPV is also more common in women than in men. A head injury or any other disorder of the balance organs of your ear may make you more susceptible to BPPV.

Although BPPV is uncomfortable, it rarely causes complications. The dizziness of BPPV can make a person unsteady, which may put him or her at greater risk of falling.

The doctor may do a series of tests to determine the cause of your dizziness. During a physical exam, the doctor will likely look for:

*Signs and symptoms of dizziness that are prompted by eye or head movements and then decrease in less than one minute

*Dizziness with specific eye movements that occur when you lie on your back with your head turned to one side and tipped slightly over the edge of the examination bed

*Involuntary movements of the person’s eyes from side to side

*Inability to control the eye movements

If the doctor can’t find the cause of your signs and symptoms, he or she may order additional testing, such as:

*Electronystagmography (ENG) or videonystagmography (VNG). The purpose of these tests is to detect abnormal eye movement. ENG (which uses electrodes) or VNG (which uses small cameras) can help determine if dizziness is due to inner ear disease by measuring involuntary eye movements while your head is placed in different positions or your balance organs are stimulated with water or air.

*Magnetic resonance imaging (MRI). This test uses a magnetic field and radio waves to create cross-sectional images of your head and body. Your doctor can use these images to identify and diagnose a range of conditions. MRI may be performed to rule out other possible causes of vertigo.

Benign paroxysmal positional vertigo may go away on its own within a few weeks or months. But, to help relieve BPPV sooner, the doctor, audiologist or physical therapist may treat the person with a series of movements known as the canalith repositioning procedure.

Canalith repositioning:

This can be performed in doctor’s office, the canalith repositioning procedure consists of several simple and slow maneuvers for positioning your head. The goal is to move particles from the fluid-filled semicircular canals of inner ear into a tiny baglike open area (vestibule) that houses one of the otolith organs in the ear, where these particles don’t cause trouble and are more easily resorbed.

Each position is held for about 30 seconds after any symptoms or abnormal eye movements stop. This procedure usually works after one or two treatments.

The doctor will likely teach the person how to perform the procedure on oneself so that he or she can do it at home if needed.

Surgical alternative:
In rare situations when the canalith repositioning procedure doesn’t work, the doctor may recommend a surgical procedure. In this procedure, a bone plug is used to block the portion of the inner ear that’s causing dizziness. The plug prevents the semicircular canal in the ear from being able to respond to particle movements or head movements in general. The success rate for canal plugging surgery is about 90%.

But the sergical option is needed in very very rare cases.

The use of medication in treating vestibular disorders depends on whether the vestibular system dysfunction is in an initial or acute phase (lasting up to 5 days) or chronic phase (ongoing). Pharmacological treatments may be used to control symptoms, accelerate central compensation, and diminish psychological comorbidity.

AYURVEDIC TREATMENT: Some effective herbs tried in vertigo: Ginger Coriander Lemongrass – helps to treat nausea and dizziness, effective in vertigo. Herbal tea prepared with lemongrass is highly effective. It will relieve the symptoms within few minutes of onset. Cayenne – contains a chemical called capsaicin which helps enhance blood flow in your brain.


The home Epley maneuver is a type of exercise help that helps to treat the symptoms of benign paroxysmal positional vertigo (BPPV).One can do this exercise at home. BPPV is caused by a problem in your inner ear.

Semont Maneuver:
*Sit on the edge of your bed. Turn your head 45 degrees to the right.

*Quickly lie down on your left side. Stay there for 30 seconds.

*Quickly move to lie down on the opposite end of your bed. …

*Return slowly to sitting and wait a few minutes.

*Reverse these moves for the right ear.

Yoga therapy :
There are several types of yoga poses, or asanas: meditative, cultural, and therapeutic poses.

Meditation helps to calm the mind and reduce anxiety. Because stress is a trigger for many vestibular patients, reducing stress can also help to minimize symptoms like dizziness and vertigo. Controlled breathing, or pranayama, is a tool that can help you control your energy level, reduce stress, increase your endurance and reduce your anxiety.

Cultural asanas are so named because they play a central role in forming a comprehensive physical culture of exercise and general well-being. Cultural asanas are sub-divided into physical asanas and relaxative asanas. Physical asanas greatly assist in rendering the body healthy, while relaxative asanas work on the Chitta (the understated aspect of consciousness) level, eliminating physical and mental tension.

Certain therapeutic poses can be helpful for different ailments, like imbalance, dizziness, diabetes, arthritis, or back pain. Yoga can be considered “therapeutic” when poses are adjusted to fit the unique needs of the practitioner. Some yoga classes are designed for special groups with unique needs, such as people with balance issues.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Help taken from:,changes%20in%20your%20head’s%20position.

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