Benign paroxysmal positional vertigo


The benign paroxysmal vertigo is harmless, but very common type of vertigo and gives the person really bad times.

*Vertigo: is the feeling of earth moving in circles around you.


 It’s enough to mention that it is the most common cause of vertigo.


The most common cause in people under age of 50 is head injury. It is also sometimes associated with migraine. In elderly the most common cause is the degeneration of the vestibular system of the inner ear. On the other hand 50% of cases are of no known reasons.

Rare causes are Viruses, minor strokes, and surgeries specially ones involving inner ear.


As I explained earlier vertigo is the feeling of earth moving around you and it’s different from dizziness which means you’re feeling yourself going in circles.

Usually vertigo occurs upon lying down, turning in bed, upon looking down, and sometimes even with moving head from right to left. Usually these episodes of vertigo last less than 45 seconds.

Minority of patients complain of nausea and vomiting.


The doctor usually makes the diagnosis through a focused interview and examination with the use of special provocation maneuvers like the DIX-Hall pike. Where the maneuver will bring the vertigo and the doctor also might notice nystagmus (rapid involuntary eye movements).


The therapy is composed of group of movements done at the doctor office called Epley or Semont maneuvers with roughly 80% cure percent. For the resistant cases the doctor may proceed into Brandt-Daroff exercises which are exercises done at home with roughly 90% cure percent.

As a last resort surgery can be done with “posterior canal plugging” being the mostly done with 90% cure rate.

Course and prognosis

The benign positional vertigo is a harmless but extremely unpleasant disease. Although it usually disappears without treatment within days to weeks still some patients may have longer duration of months to years. Therefore the therapy should not be delayed excused by the spontaneous remission.

The benign positional vertigo occurs with or without treatment in 30-50% of patients again within von 2 Jahren erneut auf.2 years.


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