Benign Paroxysmal Positional Vertigo (BPPV)

You have been added to the BPPV register by the surgical audiology department, as you have shown signs of BPPV. The following leaflet aims to answer some of your questions about the condition, but if you have any further concerns please speak to a member of clinical staff.

What is BPPV?

BPPV is a condition of the inner ear. It is a common cause of intense dizziness (vertigo), especially in older people.

• Benign means that it is not due to cancer or another serious cause; the symptoms of BPPV may be unpleasant but the underlying cause is not serious.

• Paroxysmal means recurring sudden episodes of symptoms.

• Positional means that the symptoms are triggered by certain positions. In the case of BPPV, it is certain positions of the head that trigger symptoms.

• Vertigo is dizziness with a feeling of movement. If you have vertigo you feel as if the world is moving around you or that you are moving when you are not. You feel very unsteady, a bit like being on a ship. Often you will also feel sick (nauseated), although you will not usually be sick.

What are the symptoms?

BPPV causes short episodes of intense dizziness (vertigo) when you move your head in certain directions. Vertigo is the feeling that you or your surroundings are moving.

You have been referred by your GP to the ear nose and throat (ENT) consultant who has performed a Dix Hall Pike manoeuvre. This has been followed by an Epley Manoeuvre to the ear affected by BPPV.

What causes BPPV?

• BPPV is thought to be caused by tiny solid fragments (otoconia) in the inner ear labyrinth.

• Most cases of BPPV happen in people over the age of 40, so it may be age-related.

• BPPV is one of the most common causes of vertigo in older people. However, some younger people develop BPPV following an injury to their ear, or following a previous infection in their inner ear. Sometimes it happens in younger people for no apparent reason.

• Women are affected about twice as often as men.

How is BPPV treated?

In many cases the condition gets better on its own after several weeks. However, if this does not happen a simple treatment of moving the head into various positions over a few minutes can cure the condition in many cases. This treatment is called the Epley Manoeuvre.

Surgery is extremely rare, as in most cases the condition either improves by itself or can be cured by the Epley Manoeuvre.

What is the Epley Manoeuvre?

This is a simple cure that may be tried by your doctor. This is done by a series of four movements of your head. After each movement, your head is held in the same place for around 30 seconds. The treatment uses gravity to move the tiny fragments away from where they are causing problems. Moving your head in this way causes the otoconia fragments to move and settle where they will cause no further symptoms.

Can I drive with BPPV? Can I continue to work and / or play sport during active phases of BPPV?

• The DVLA recommends that you should stop driving if you have sudden, unexpected, and disabling attacks of dizziness.

• You should tell your employer if BPPV could pose a risk to yourself or others in your job. For example, if you use ladders, operate heavy machinery, or drive.

• To avoid falls around the home, get out of bed slowly and avoid jobs around the house that involve looking upwards.

• You should be able to return to normal activities once your BPPV has settled.

What if my symptoms return?

Should your symptoms return please contact the Audiology Department and we will arrange an appointment for a senior audiologist to see you in clinic.

• Audiology Department, Kent and Canterbury Hospital
  Telephone: 01227 864252
  Lines open: Monday, Tuesday, and Thursday, 10am to 12 noon and 2pm to 4pm
  Email