About 20 percent of all dizziness is caused by benign paroxysmal positional vertigo (BPPV). By age 70, about half of the population will experience this disorder at least once.

BPPV is marked by a recurring sense of spinning, dizziness, falling, tumbling or nausea that usually lasts less than 30 seconds. This balance disorder stems from an inner ear problem.

Causes of BPPV
BPPV is the most common form of vertigo - a sense of spinning. It results when tiny calcium particles (also called canaliths or ear stones) settle in part of the inner ear. The misplaced ear stones exaggerate the brain's response to movement. BPPV may be linked to ear infections, head injuries or aging. It may also occur because of Meniere's disease (another inner ear disorder) or migraines. Half of all cases occur for no known reason.

Diagnosing BPPV
BPPV may occur when you make certain head movements - such as when you roll over in bed. If you have vertigo or feel dizzy after certain head movements, talk to your doctor.

Your doctor will ask what triggers your symptoms and may ask what medications you are taking. A physical exam may be done to check your heart, blood pressure and nervous system.

To test for BPPV, your doctor may move your head while monitoring your eye movements. When your brain's response to movement doesn't match what the eyes see, your eyes may make a "jumping" movement called nystagmus. Your doctor may seek the opinion of an ear, nose and throat (ENT) specialist. ENT doctors also specialize in balance disorders.

Treating BPPV
Medication may help if you have nausea resulting from vertigo.

To treat BPPV, your doctor will direct you through a series of specific head movements, which will loosen and reposition the ear stones.

Your doctor may also show you how to perform similar head maneuvers at home to help loosen and spread the stones.

If head maneuvers don't work, your doctor may recommend a surgical procedure to block the canal.

BPPV is uncomfortable, but not dangerous. It usually improves within six months.

External Sources Parnes LS, Agarwal SK, Atlas J. Diagnosis and management of benign paroxysmal positional vertigo (BPPV). CMAJ. Accessed August 15, 2007. Vestibular Disorders Association. Benign paroxysmal positional vertigo (BPPV). Accessed August 15, 2007. Vestibular Disorders Association. Canalith repositioning procedure (CRP) - for Treatment of BPPV. Accessed August 15, 2007.