Benign Paroxysmal Positional Vertigo (BPPV) – Definition, Prevention and Treatment

It is one of the most common causes of vertigo.

The most common symptom describes the sensation of intense dizziness of the head.

This kind of vertigo describes the situation in which the feeling of dizziness lasts only a few minutes and often stops on its own. There may be recurrent episodes without any specific reason or cause.

Although there are many causes of vertigo, it is the term used for vertigo that comes and goes (paroxysmal) without a specific associated disease (benign).

It is often frustrating for patients because the episodes are frightening and challenging to predict. However, it is related to the labyrinth system within the inner ear.

The labyrinth system is found in the inner ear and is responsible for maintaining balance in the body.

Three semicircular canals contain nerve endings and fluids that indicate to the body where it is about gravity, acting almost like a gyroscope.


The tiny crystals (coprolites) are placed on top of the nervous stems, and if they fall, they can cause irritation to the liquid contained in the ducts, and this can cause vertigo, the sensation that the head rotates about the rest of the world.

Some researchers also suggest that, in addition, some floating particles in the labyrinth system exert a force that can cause vertigo symptoms.

Many people have experienced the sensation of spin (vertigo). After turning for some time and then stopping quickly, there is a feeling that the dizziness continues for a few seconds and, sometimes, tends to fall.

This occurs because the fluid in the semicircular canals rotates after the head has stopped. This gives the person a feeling of vertigo.

This can also occur during or after a ride in an amusement park, and there may be associated nausea and vomiting if the vertigo is severe enough.


The vertigo cause is often a mystery, and in almost half of the cases, the reason is never found. It is unclear why small particles (crystals) fall off inside the inner ear.

It can be due to minor head injuries or repetitive movements of the head (for example, the movement of the lead-up and down that occurs when working in front of a computer screen).

Other causes can be the following:

  • Viral infections,
  • Inflammation of the nerve (neuritis),
  • A complication of ear surgery (more common in older people and women),
  • Side effects of medications,
  • Fast movements of the head.


The symptoms are the same sensations that people experience when they turn in a swivel chair or on a ride in an amusement park, and suddenly they stop.

Vertigo is a feeling of dizziness. Individuals may use the word “vertigo,” although this is a problematic term for a health professional to understand.

There is a difference between dizziness and lightheadedness, or the sensation of being unstable is not accompanied by dizziness.

  • Loss of balance and fall.
  • Nausea or vomiting
  • Nystagmus (involuntary movements of the eyes).

Several medications, including common remedies for motion sickness, can relieve symptoms and be used for less severe episodes of vertigo.

  • Meclizina (Antivert, Bonine, Dramamine II, D-Vert)
  • Diazepam (Valium)
  • Dimenhidrinato (Dramamina)
  • Prometazina (Phenergan)
  • Scopolamine (Isopto, Scopace)

If you think that the cause of vertigo is due to a viral infection, you can prescribe antiviral drugs such as acyclovir (Zovirax).

Steroids such as prednisone may be helpful if nerve inflammation is a potential reason for vertigo.


Most cases do not have a known cause; therefore, prevention is impossible. There may be an association with minor head injuries or the change of head position repeatedly, for example, working with a computer and constantly looking up and down on the monitor.

At one age, it is reasonable to change positions a little more slowly to prevent vertigo potentially.


The benign paroxysmal positional vertigo (BPPV) is characterized by rotatory dizziness triggered by head movements caused by the hyperextension of the neck and when the patient wakes up or sleeps in bed.

A series of treatments for BPPV have been proposed, including drugs, surgery, and vestibular rehabilitation exercises.

The litíase dome and the theories of ductal lithiasis allowed the creation of maneuvers to clean the crown and the semicircular ducts of fragments of estate one.

Despite the high efficacy of the treatments and the possible spontaneous resolution, in 20% to 30% of the patients, the disease may reappear or persist.

In cases of recurrence of BPPV, the repetition of maneuvers helps shorten the duration of dizziness.

However, the persistent form does not respond to treatment, and additional strategies may be necessary, such as vestibular rehabilitation exercises, suppressive vestibular function drugs, and surgical procedures.

Many authors highlight the benefits of vestibular rehabilitation exercises on the ground in improving balance and vestibular compensation.

Some researchers developed an aquatic physiotherapy protocol as a method of vestibular rehabilitation for patients with vestibular balance disorders and observed that patients with the unilateral peripheral vestibular syndrome (SVPU), characterized by hypo or hyperreflexia calorie had improvements in their self-perception of dizziness, quality of life and performance in computerized dynamic posturography when evaluated before and after such treatment.

Although paroxysmal vertigo tends to be a condition that has not found permanent relief, correct therapy can alleviate its long-term symptoms and improve the patient’s quality of life.