Benign Paroxysmal Positional Vertigo (BPPV) Quiz
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Dizziness
Spinning feeling
Nausea when I move my head
Dizziness multiple times
Have nausea
Off-balance like floating
Dizziness when looking up
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What is Benign Paroxysmal Positional Vertigo (BPPV)?
Benign paroxysmal positional vertigo occurs when calcium crystals become trapped in the semicircular canals, a part of the inner ear that controls balance. Usually, only one ear is affected. It is characterized by sudden vertigo (a feeling of instability and the room spinning) due to abrupt changes in head position.
Typical Symptoms of Benign Paroxysmal Positional Vertigo (BPPV)
- Dizziness
- Nausea when moving head
- Pain at the back of the head
- I feel like I'm spinning around / vertigo
- Repeated dizziness / vertigo
- Dizziness when turning over in bed after waking up
- Forehead pain
- Dizziness when tilting the head upwards
Diagnostic Questions for Benign Paroxysmal Positional Vertigo (BPPV)
Your doctor may ask these questions to check for this disease:
- Do you feel dizzy?
- Do you experience nausea when moving your head?
- Do you have pain at the back of your head?
- Do you feel like your surroundings are spinning?
- Do you experience repeated episodes of dizziness/vertigo?
Treatment of Benign Paroxysmal Positional Vertigo (BPPV)
BPPV may resolve on its own within a few weeks. A doctor may also perform a simple repositioning maneuver to relocate the trapped crystals causing BPPV and may recommend exercises and physical therapy.
Reviewed By:
Unnati Patel, MD, MSc (Family Medicine)
Dr.Patel serves as Center Medical Director and a Primary Care Physician at Oak Street Health in Arizona. She graduated from the Zhejiang University School of Medicine prior to working in clinical research focused on preventive medicine at the University of Illinois and the University of Nevada. Dr. Patel earned her MSc in Global Health from Georgetown University, during which she worked with the WHO in Sierra Leone and Save the Children in Washington, D.C. She went on to complete her Family Medicine residency in Chicago at Norwegian American Hospital before completing a fellowship in Leadership in Value-based Care in conjunction with the Northwestern University Kellogg School of Management, where she earned her MBA. Dr. Patel’s interests include health tech and teaching medical students and she currently serves as Clinical Associate Professor at the University of Arizona School of Medicine.
Rohini R, MD (Otolaryngology (ENT))
Dr. Rohini R is an ENT, Head and Neck Surgeon, with a Fellowship in Advanced Endoscopic Sinus and Skull Base Surgery and a Fellowship in Aesthetic Medicine and Lasers. Besides clinical practice and working with Ubie, she is actively training and mentoring medical students and residents. She has functioned in various work settings - teaching hospitals, private and free health centers, and worked with patients from all socioeconomic backgrounds due to her experience in free hospitals and volunteering in India and Singapore.
Content updated on Apr 4, 2024
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Benign Paroxysmal Positional Vertigo (BPPV)?
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People with similar symptoms also use Ubie's symptom checker to find possible causes
- A sense of motion or spinning (vertigo)
- Feeling faint
- Dizzy when standing up
- Dizzy in the morning
- Lightheadedness when I am standing
- Ringing in the ears and dizziness
- Dizziness after straining my muscles
Symptoms Related to Benign Paroxysmal Positional Vertigo (BPPV)
Diseases Related to Benign Paroxysmal Positional Vertigo (BPPV)
FAQs
Q.
Dizziness? Why Your Head Is Spinning & Medically Approved Next Steps
A.
There are several factors to consider. Dizziness can mean vertigo, lightheadedness, or imbalance, most often from inner ear problems like BPPV, dehydration or low blood pressure, anxiety, or medications, and less commonly from serious neurologic causes. Start by sitting or lying down, hydrating, eating if needed, moving slowly, and avoiding driving during vertigo, and seek urgent care for red flags like severe headache, chest pain, fainting, weakness, speech trouble, or vision changes; for complete next steps, including when maneuvers like Epley may help and when to see a doctor, see below.
References:
* Strupp M, Brandt T. Dizziness: a practical, evidence-based approach to diagnosis and management. Br J Gen Pract. 2017 Mar;67(656):127-129. doi: 10.3399/bjgp17X689264. PMID: 28246231; PMCID: PMC5325992.
* Welgampola MS, Sequeira A. The dizzy patient: a practical approach. Med J Aust. 2018 Aug;209(4):175-181. doi: 10.5694/mja17.00971. PMID: 30111306.
* Sacco M, Custer J. Evaluation of Dizziness in Adults. Am Fam Physician. 2018 Nov 1;98(9):571-578. PMID: 30372036.
* Fife TD, Gubbels SP, Smouha EE, O'Malley SO, Edlow JA, El-Kashlan H, Kentala E, Mahoney MC, Ogren MA, Roland PS, Tunkel DE, Corrigan MD. Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update). Otolaryngol Head Neck Surg. 2023 Feb;168(2):220-250. doi: 10.1177/01945998221142517. Epub 2023 Jan 2. PMID: 36594950.
* Otero-Millan G, Kheradmand A. Central Vertigo. Semin Neurol. 2019 Oct;39(5):561-572. doi: 10.1055/s-0039-1694764. Epub 2019 Oct 3. PMID: 31581001.
Q.
Is the Room Spinning? Why Your Balance Fails & Medical Steps for Vertigo Relief
A.
Vertigo is a spinning or tilting sensation caused by mismatched signals from your inner ear, eyes, and balance system; the most common cause is BPPV, often relieved quickly with the Epley maneuver, though infections, Ménière’s disease, and migraine can also be responsible, and stroke is a rare but urgent concern. Seek emergency care if vertigo comes with weakness, trouble speaking, vision changes, severe headache, chest pain, fainting, or new confusion. There are several factors to consider for diagnosis and relief, including vestibular rehab, short-term medications, and condition-specific treatments; see below for complete details, key triggers to watch, safety steps, and guidance that could affect which next steps you take with your doctor.
References:
* Fife TD. Vertigo: Diagnosis and Treatment in Primary Care. Am J Med. 2021 Apr;134(4):453-458. doi: 10.1016/j.amjmed.2020.12.016. Epub 2021 Jan 18. PMID: 33476686.
* Toussaint P, Deggouj N, Jacquesson T, et al. Management of vertigo: a review of the latest developments. Curr Opin Neurol. 2022 Feb 1;35(1):103-110. doi: 10.1097/WCO.0000000000001016. PMID: 34914902.
* Nardone R, Golaszewski S, Schönhuber R, et al. Update on the Physiopathology and Diagnostic Tools in Vertigo. J Clin Med. 2021 Mar 17;10(6):1227. doi: 10.3390/jcm10061227. PMID: 33800673; PMCID: PMC8000494.
* Hilton MP, Pinder DK. Benign Paroxysmal Positional Vertigo: A Review of Diagnosis and Management. Clin Otolaryngol. 2021 Apr;46(2):330-336. doi: 10.1111/coa.13682. Epub 2020 Dec 28. PMID: 33289047.
* Sajjadi SM, Paparella MM. Meniere's Disease: An Update on Pathogenesis, Diagnosis, and Treatment. Med Clin North Am. 2022 Jan;106(1):127-138. doi: 10.1016/j.mcna.2021.08.006. Epub 2021 Sep 18. PMID: 34823793.
Q.
Spinning Room? Why Your Body is Crashing & Medically Approved Promethazine Next Steps
A.
Vertigo that makes the room feel like it is spinning and leaves you crashed is often from treatable issues like BPPV, vestibular neuritis or labyrinthitis, migraine, dehydration, or low blood pressure; seek urgent care if you also have severe headache, slurred speech, one-sided weakness, chest pain, fainting, or vision loss. Promethazine can be medically appropriate for short-term control of vertigo-related nausea and vomiting but it does not fix the cause and has safety cautions. There are several factors to consider; see the complete steps and safety details below to choose the right next actions, including hydration, careful movements, trigger tracking, and when maneuvers like Epley or a doctor visit are needed.
References:
* Dieterich M, Brandt T. Vertigo and Dizziness: An Update. Curr Opin Neurol. 2017 Feb;30(1):89-94. doi: 10.1097/WCO.0000000000000412. PMID: 27926521.
* Penner IK, et al. Understanding the multifactorial causes of fatigue: a review. Mult Scler J Exp Transl Clin. 2021 Jun 23;7(2):20552173211025595. doi: 10.1177/20552173211025595. eCollection 2021 Apr-Jun. PMID: 34188730.
* Sharma N, et al. Promethazine: a comprehensive review of its pharmacology, therapeutic uses, and adverse effects. Indian J Pharmacol. 2020 Jan-Feb;52(1):10-17. doi: 10.4103/ijp.ijp_490_19. PMID: 32051662.
* Le N, et al. Pharmacological treatment of acute vertigo: a systematic review. Laryngoscope Investig Otolaryngol. 2020 Feb 28;5(2):169-178. doi: 10.1002/lio2.361. eCollection 2020 Apr. PMID: 32258485.
* Kim JS, et al. Diagnostic Approach to Dizziness. J Clin Neurol. 2019 Jul;15(3):334-343. doi: 10.3988/jcn.2019.15.3.334. Epub 2019 Jul 1. PMID: 31250553.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1References
Lou Y, Cai M, Xu L, Wang Y, Zhuang L, Liu X. Efficacy of BPPV diagnosis and treatment system for benign paroxysmal positional vertigo. Am J Otolaryngol. 2020 May-Jun;41(3):102412. doi: 10.1016/j.amjoto.2020.102412. Epub 2020 Feb 4. PMID: 32057490.
https://www.sciencedirect.com/science/article/abs/pii/S0196070920300831?via%3DihubVaduva C, Estéban-Sánchez J, Sanz-Fernández R, Martín-Sanz E. Prevalence and management of post-BPPV residual symptoms. Eur Arch Otorhinolaryngol. 2018 Jun;275(6):1429-1437. doi: 10.1007/s00405-018-4980-x. Epub 2018 Apr 23. PMID: 29687182.
https://link.springer.com/article/10.1007/s00405-018-4980-xJacobson GP; Editor-in-Chief. The "Reversal Nystagmus" in BPPV. J Am Acad Audiol. 2021 Jan;32(1):1-2. doi: 10.1055/s-0041-1723791. Epub 2021 Apr 19. PMID: 33873211.
https://www.thieme-connect.de/products/ejournals/abstract/10.1055/s-0041-1723791Uz U, Uz D, Akdal G, Çelik O. Efficacy of Epley Maneuver on Quality of Life of Elderly Patients with Subjective BPPV. J Int Adv Otol. 2019 Dec;15(3):420-424. doi: 10.5152/iao.2019.6483. PMID: 31846923; PMCID: PMC6937179.
https://advancedotology.org//en/efficacy-of-epley-maneuver-on-quality-of-life-of-elderly-patients-with-subjective-bppv-131456BPPV - Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/vertigo/symptoms-causes/syc-20370055