What's Benign Paroxysmal Positional Vertigo?

Benign paroxysmal positional vertigo is one of the most common causes of vertigo. It makes the sufferer feel that everything is spinning inside or outside their heads.

Reviewed and approved by the pharmacist María Vijande.

Written by María Vijande

Last update: 27 May, 2022

Benign paroxysmal postural vertigo is an inner ear problem. It consists of the onset of sudden and brief vertigo episodes. In this sense, this vertigo is caused by position changes and is often accompanied by nystagmus. In general, benign paroxysmal postural vertigo happens when you get into a position that triggers it.

Also, it’s one of the most common causes of vertigo. It makes the sufferer feel that everything is spinning inside or outside their heads. Benign paroxysmal postural vertigo is the leading cause of vertigo in primary care consultation. In addition, it represents up to 25% of patients who have vertigo. It usually occurs in people between the ages of 40-50 and up to 50% of cases aren’t due to a known cause.

Although it can be an annoying problem, it’s rarely serious, except when it increases your chances of falling.

Symptoms of benign paroxysmal postural vertigo

This condition causes brief dizziness episodes. These dizziness episodes may be mild to severe. Also, they’re often triggered by specific changes in head position. Dizziness may occur when you tilt your head up or down, when you lie down, or when you turn in bed. In this sense, you may feel that the room is spinning or moving. This leads to a sensation called vertigo.

Here are the other symptoms that can occur:

• Nausea and dizziness. Both sensations usually disappear within a few seconds.
• Nystagmus. Involuntary eye movements.
• Inability to control eye movements.

In people over 65, this condition can go unnoticed and only manifest with instability related to position changes. To diagnose these patients, it’s essential to do a symptom provocation test.

What causes benign paroxysmal positional vertigo?

The inner ear contains tiny calcium particles that allow you to keep your balance. When you move your head, these particles stimulate nerve cells. As a consequence, the nerve cells send a sign to the brain indicating which direction the head is moving. When calcium particles are distributed abnormally through the ear canals, nerve cells tell the brain that the head has moved more than it has actually moved. This “wrong sign” that reaches the brain is vertigo.

In addition, this disorder can also be associated with aging or occur as a result of a blow to the head.

Treatment

Benign paroxysmal positional vertigo may disappear on its own in a few weeks or after a few months. However, to help relieve your symptoms more quickly, you can practice the canalith repositioning procedure.

What’s the canalith repositioning procedure?

This is a procedure that involves making several simple and slow maneuvers to position your head. As a result, its goal is to move the inner ear particles to the vestibular labyrinth, where these particles don’t cause problems and are more easily reabsorbed.

To do this, you have to hold each position for 30 seconds after any symptom or abnormal eye movement disappears. The canalith repositioning procedure is usually effective after one or two treatments.

Surgical alternative

In rare situations, the canalith repositioning procedure isn’t effective. For these cases, the doctor may recommend a surgical procedure.

In the surgery, a bone plug is used in order to block the part of the inner ear that’s causing dizziness. Thus, the plug prevents the ear’s semi-circular canal from responding to particle movements or head movements in general.

Above all, the success rate of semi-circular canal occlusion is approximately 90%. However, benign paroxysmal positional vertigo may occur again, even after completing treatment successfully. Although there’s no cure for this condition, you can control it with the help of specialists such as physical therapists.