Benign Paroxysmal Positional Vertigo (BPPV)

BPPV is a problem involving the vestibular system, which is in the inner ear. It's a common underrecognized cause of falls, and is most common between the ages of 50-80. The vestibular system has sensors that tell the brain about head movement for maintaining standing balance. There are calcium carbonate crystals (also called "ear rocks") in one part of the vestibular system (inner ear)  which can become dislodged and move into a different part of the vestibular system. This produces the symptoms of BPPV, dizziness with spinning and imbalance.

Older adults may have unrecognized BPPV. The older adult may not report spinning sensations when they have BPPV. They may report a sense of imbalance. This imbalance may lead to falls.

If someone answers yes to the following screening questions, testing for BPPV is recommended:

• Do you have dizziness getting into/out of bed?
• Do you have dizziness rolling in bed?

BPPV is diagnosed by placing the head in specific positions to cause movement of the "ear rocks", which also causes dizziness. Treatment of BPPV involves moving the head through a series of movements to move the "ear rocks" from where they are causing a problem back to where they belong. Treatment for BPPV has been shown to decrease fall incidence, number of falls, and fear of falling.

Following appropriate treatment for BPPV, some people feel better immediately. Some people feel a sense of disorientation and imbalance that lingers for several days to several weeks. These people may benefit from additional testing and treatment for any remaining balance problems. Fall risk can be assessed with various tests that look at balance and walking.

Physical therapists have specialized training in vestibular rehabilitation and can often quickly improve symptoms and reduce the risk for falls.  Valley Medical Center's Outpatient Therapy Services Departments have physical therapists available to treat BPPV and other vestibular conditions.  

Additional information can be found at Valley Medical Center | Outpatient Therapy