Benign Paroxysmal Positional Vertigo (BPPV)
Information for patients from the Audiology Department
You have been added to the BPPV register by the Audiology Department, as you have shown signs of BPPV. This leaflet explains:
what BPPV is
what the symptoms are, and
how BPPV is treated.
If you have any questions after reading this leaflet, 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 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.
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 clear reason.
Women are affected about twice as often as men.
How is BPPV treated?
Often the condition gets better on its own after several weeks. If this does not happen, a simple treatment involving moving your 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. In most cases, the condition either improves by itself or can be cured by the Epley Manoeuvre.
What is the Epley Manoeuvre?
The Epley Manoeuvre is a simple cure that may be tried by your doctor, and can be performed safely at home. This is done with a series of four head movements.
After each movement, your head is held in the same place for around 30 seconds.
The treatment uses gravity to move otoconia fragments away from where they are causing problems. Moving your head in this way causes the fragments to move and settle where they will cause no further symptoms.
How do I perform the Epley Manoeuvre at home?
We recommend that you have a friend or family member with you the first few times you perform this exercise. They will be able to help you in case you become unsteady.
Watch the treatment being performed on this YouTube video.
To perform the exercise, you will need to follow the steps below.
Sit up on your bed with your head turned 45 degrees to the affected ear.
Lie down on your back as quickly as you can. Hang your head over the edge of your bed. Make sure you keep your head turned 45 degrees to the affected ear. Wait for one minute, or until your dizziness goes away.
Slowly turn your head 45 degrees to the other side. Keep your head down and hanging over the edge of your bed. Wait for one minute, or until your dizziness goes away.
Turn to lie on your side, making sure you do not lift your head up. Then turn your head slightly so you are facing the floor. Wait for one minute, or until your dizziness goes away.
Slowly sit up, tilting your head down to tuck your chin into your chest.
Will using the Epley Manoeuvre cure my BPPV?
Some studies report that the Epley Manoeuvre is successful in stopping symptoms in about eight in 10 cases (80%) with just one treatment.
If the first treatment does not work, there is still a good chance that it will work in a repeated treatment session, a week or so later. If symptoms return at a later date, the Manoeuvre can be repeated.
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. We will arrange an appointment for you to see a senior audiologist in clinic.
Audiology Department, Kent and Canterbury Hospital
Telephone: 01227 864252
Lines open: Monday to Friday, 10am to 12 noon and 2pm to 4pm
Email