| name: | Benign Positional Vertigo |
| also known as: | Benign Paroxysmal Positional Vertigo; Postural Vertigo; Benign Vertigo; Positional Vertigo; BPV |
| also see: | Vertigo; Dizziness; Motion Sickness; Tinnitus; Difficulty Walking |
| description: | Benign positional vertigo, is a form of vertigo with spinning dizziness that lasts for several seconds to less than a minute, brought on by certain head positions or turning of the head. Also associated with ringing in the ears called tinnitus and nausea. Part of a person's balance system is in the inner ear balance mechanism (semicircular canals), where tiny calcium crystals acting like shifting sand, under the influence of gravity, send impulses to the brain regarding spatial orientation. Any disturbance in this mechanism can lead to vertigo. Benign positional vertigo is usually always characteristic for a certain head turn, such as rolling over in bed to the left, but not to the right. Causes of malfunction can include head injury, concussion, middle ear infection, viral vertigo also called labyrinthitis, and ear surgery. Benign positional vertigo seldom involves both ears. |
| signs & symptoms: | Includes vertigo (sensation of spinning either the person is spinning or the surroundings are spinning) usually brought on with a certain head movement each and every time, lasting for seconds to less than one minute, as well as nystagmus (rapid eye movement). |
| diagnosis: | Based on signs, symptoms, history, exam, as well as hearing test, balance test (ENOG=electronystagnogram), and brain MRI Scan. The balance test can usually determine which is the involved ear. Differential diagnosis includes Meniere's disease, brain tumor, migraine headache. |
| treatment: | Since only certain head positions cause the vertigo, treatment is simply avoiding those provocative positions. Should a spell of vertigo occur, it is self limited and benign. Medication is not prescribed on a regular basis since episodes of vertigo are so sporadic and far between. However, Frequent prolonged acute attacks can be treated with valium, antihistamines and nausea drugs for nausea and vomiting. Cawthorne exercises might be recommended which are basically exercises designed to actually cause the vertigo and thereby retrain the brain to eventually ignore the aberrant signals. Severe frequent cases of benign positional vertigo might be relieved by surgery, called vestibular neurectomy, where a technically elegant operation is performed to cut the balance nerve. Complications of surgery can include persistent vertigo and also complete deafness in that ear. |
| prevention: | None. |
| outcome: | Many cases of benign positional vertigo burn out on their own after several years. If it does not burn out it is also not progressive, and most people learn to live with it. Severe cases of benign positional vertigo might be relieved by surgery. |
skynetMD suggests the following:
| if: | If the person has decreased hearing in association with vertigo, uncontrollable vomiting, seizure activity, fainting, fever |
| go to: | Go to the hospital |
| if: | If the person has labyrinthitis, including vertigo, dizziness, eye movement, nausea, loss of balance |
| go to: | Go to the doctor |
| if: | If the person has vertigo, and is under the care of a doctor, they should not drive, avoid heights, rest, keep the head absolutely still, avoid salt, and |
| go to: | Go to the pharmacy for an over the counter nonprescription motion sickness medicine, such as antihistamines, meclizine, benadryl. |
Last updated 11/8/2009