Treatments for The Most Common Type of Vertigo by Intermountain Health

Benign paroxysmal positional vertigo (BPPV) is the sudden sensation that your head is spinning or that your body is spinning and it’s one of the most common causes of vertigo.

About 20% of people who see a doctor for vertigo are diagnosed with BPPV, a peripheral vertigo, which is a disorder within the vestibular system in the inner ear.

“When you feel dizzy or your head is spinning, it can be very intense and difficult to think of anything else, except how to get relief,” said Mindy Norris, AuD, an audiologist at the Intermountain TOSH Hearing and Balance Center. “It can trigger disorientation, nausea, and vomiting which is why it’s important to seek treatment.”

Causes of BPPV
BPPV is caused by a problem in the semicircular canals in your inner ear. The semicircular canals contain fluid and hair-like sensors that send signals to your brain about the position of your head. This helps you maintain your balance and when not functioning correctly can put you at risk for falls.

BPPV happens when the calcium carbonate crystals in the inner ear that help detect the pull of gravity become loose, confusing the signal to your brain.

BPPV can be caused by congenital disorders of the inner ear and occasionally it has been associated with a history of small strokes or Meniere’s disease. It can also come from the following:
•    Breakdown of the utricle over time
•    Bike riding on rough trails
•    High intensity workouts – like aerobics
•    Leaving the head in a position for a long time – like at the dentist or in bed
•    An inner ear disease (ischemic, inflammatory, infectious)
•    Head trauma

Symptoms of BPPV
Often symptoms of BPPV are reported with specific changes in the position of the head, such as lying down, rolling over, or tilting your head to get up.

Symptoms of BPPV can sometimes go away or lessen in severity after about six months.

Diagnosis and Treatment
To determine of the cause of vertigo is BPPV, a doctor or physical therapist will perform a test called the Dix-Hallpike maneuver.

The evaluator will move the head in certain positions, looking for abnormal eye movements and asking if the positions reproduce the feeling of spinning.

If this test is positive, the problem can be corrected with the Epley maneuver. This is a sequence of movements that will move the calcium particle out of the semicircular canal. A doctor or physical therapist can guide a patient through the movements in a session that will take about 10 minutes. Symptoms are usually resolved with one treatment.

It is important to have any symptoms of vertigo evaluated by a healthcare provider as it can be associated with other problems, such as Meniere’s disease, vestibular neuritis, migraine headaches, head or neck injury, stroke, brain tumors, or certain medications.

For more information on BPPV or other hearing and balance disorders and to find a provider near you, go click here.

Mindy Norris, AuD is a doctor of audiology with the TOSH Hearing and Balance Center in Murray, Utah.

About Intermountain Health

Headquartered in Utah with locations in seven states and additional operations across the western U.S., www.intermountainhealth.org is a nonprofit system of 33 hospitals, 385 clinics, medical groups with some 3,900 employed physicians and advanced care providers, a health plans division called Select Health with more than one million members, and other health services. Helping people live the healthiest lives possible, Intermountain is committed to improving community health and is widely recognized as a leader in transforming healthcare by using evidence-based best practices to consistently deliver high-quality outcomes at sustainable costs. For more information or updates, see https://intermountainhealthcare.org/news.