What is Benign Paroxysmal Positional Vertigo (BPPV)?

Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo. This occurs when calcium crystals in the inner ear, called otoconia, become dislodged from their normal location and float through the inner ear canal. If the crystals land in the semicircular canal–the portion of our ear that provides information to our brain about rotational movement–it causes a false sensation of spinning or whirling.

Typically, BPPV occurs in conjunction with sudden movements, such as looking up, turning one’s head quickly or rolling over in bed. These episodes generally last only a minute or two, but they can be disorienting and even dangerous. As a result, those who suffer from BPPV may reduce or eliminate normal activities for fear they will trigger vertigo.

If you are experiencing recurrent episodes of vertigo, it is important to seek a professional medical diagnosis. The doctors at Sierra Nevada Ear, Nose & Throat can evaluate your situation and provide effective BPPV treatment.



The name benign paroxysmal positional vertigo outlines the hallmarks of the disorder:

  • Benign: not life-threatening
  • Paroxysmal: sudden, brief sensory disruption
  • Positional: in relation to specific placement or movement of the head
  • Vertigo: spinning or whirling sensation

These episodes of vertigo can be accompanied by rapid, uncontrolled eye movements, loss of balance and nausea or vomiting.

When a patient comes to Sierra Nevada ENT complaining of the symptoms above, our doctors first take a detailed medical history and chart the onset, severity, frequency and duration of symptoms. We also perform a test known as the Dix-Hallpike maneuver.

The Dix-Hallpike maneuver is a series of guided movements that includes turning the patient’s head 45 degrees to each side while laying down on the exam table. Feelings of vertigo and specific eye movements (called nystagmus) during this maneuver are an indication of BPPV.

BPPV is more common than many people realize. In fact, research from the Mayo Clinic estimates that 1.5 percent of the U.S. population will experience BPPV in any given year. The good news is that, once our doctors at Sierra Nevada ENT have made a BPPV diagnosis, we can create an individualized, effective treatment plan to reduce or even eliminate vertigo.

What Causes BPPV?

There is no single cause of BPPV, and it is often difficult to pinpoint a particular reason that symptoms develop. Studies have shown that onset may be linked to:

  • Head trauma
  • Certain medical conditions, including inner ear infection, migraines, osteoporosis or diabetes
  • High-intensity activities or jostling movements, such as aerobics or mountain biking
  • Long periods with little or no head movement, such as recovering from illness or injury or even reclining in a dentist’s chair

Age also appears to be a factor. According to the International Journal of Otolaryngology, most incidences of “spontaneous” BPPV occur in adults between 50 and 70 years old. Approximately 10 percent of individuals over 60 have experienced a BPPV episode, a rate 7 times that of the general population.

Once BPPV symptoms develop, it is possible that they resolve on their own. However, if you are experiencing vertigo, it is best to seek care from a medical professional. An ear, nose and throat specialist will be able to diagnose BPPV and provide a treatment plan to reduce or prevent future episodes.

How Balance Therapy Helps

The healthcare professionals at Sierra Nevada Ear, Nose & Throat provide a variety of effective balance therapy options for BPPV treatment.

Balance therapy consists of physical exercises that teach your body and brain to compensate for the disruption to your sensory system. Balance therapy generally falls into one of three categories–habituation, gaze stabilization or balance training. While each balance therapy method targets a different issue, all involve consistent exposure and movements that build upon one another gradually in a safe and professional setting.

There are several therapy methods that have proven particularly effective for BPPV treatment. The most common one is known as the Epley maneuver. This series of therapist-led movements is designed to dislodge calcium crystals from the posterior semicircular canal, where they have been impacting the patient’s sense of rotational movement. Once dislodged, they can be replaced into their proper location. It may take as little as one or two treatments to reduce or eliminate vertigo.

Other balance therapy exercises may also be used. Habituation exercises, for example, aim to decrease the severity of a response through repeated exposure to the problematic stimuli. It works best with patients who experience dizziness or instability in conjunction with sudden movements, such as BPPV.

Treating BPPV and Other Types of Vertigo

With locations in Reno, Carson City, Gardnerville and Fallon, Sierra Nevada ENT has been proudly serving the Northern Nevada area for over 25 years. Today, our Center for Vestibular Rehabilitation specializes in balance therapy for patients with a variety of vestibular disorders, including BPPV and other types of vertigo.

We offer physical therapy in a caring, safe and professional setting. Our team is committed to helping patients alleviate symptoms associated with BPPV and other vestibular disorders. We tailor each vestibular therapy program to a patient’s specific needs, helping them reduce symptoms and return to normal daily function.

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