Sudden Dizziness? It Could Be Benign Paroxysmal Positional Vertigo (BPPV)

Sometimes, you might experience sudden dizziness, even with simple movements like standing up quickly from bed or tilting your head. While it may be a brief episode, recurrent dizziness could signal a medical condition, such as Benign Paroxysmal Positional Vertigo (BPPV).

BPPV affects the inner ear, causing short but intense bouts of dizziness, usually triggered by head movements. Although generally not dangerous, it can increase the risk of falls and injuries, especially in older adults.

What Is Benign Paroxysmal Positional Vertigo?

BPPV is a disorder of the inner ear, specifically the vestibular system, which helps maintain balance. Inside the ear are fluid-filled canals that allow the brain to detect the position and movement of the head.

Normally, tiny calcium carbonate crystals reside in a structure called the utricle. In BPPV, these crystals dislodge and move into one of the semicircular canals. When the head moves, these crystals shift abnormally, sending incorrect signals to the brain, causing a spinning sensation—even with simple movements.

Symptoms of BPPV

According to Mayo Clinic, BPPV symptoms are usually brief and intermittent but can be highly disruptive:

Sudden dizziness when changing head position (lying down, turning in bed, sitting, or standing quickly).
Feeling like the surroundings are spinning (vertigo).
Loss of balance or unsteadiness while standing or walking.
Nausea or vomiting in severe cases.
Abnormal eye movements during an episode.

A vertigo episode usually lasts about a minute, but repeated episodes can increase risk. Some patients may feel unsteady even between episodes.

Causes of BPPV

BPPV often has no clear cause, but several factors increase the likelihood:

Head injury: Trauma can displace the inner ear crystals.
Age: Aging can weaken the inner ear structures, leading to dizziness.
Inner ear disorders: Previous infections or other ear problems can predispose someone to BPPV.
Osteoporosis: Studies show a link between weak bones and increased BPPV risk, especially in older adults.

Diagnosis of BPPV

Diagnosis relies on medical history, symptom description, and clinical examination. Doctors may perform head movement tests to observe eye responses during vertigo episodes. Additional tests may be required if symptoms are atypical or involve both ears.

Treatment of BPPV

The good news: BPPV is usually treatable without surgery. Treatment involves specific maneuvers performed by a doctor or physical therapist to reposition the crystals back to the utricle.

Common approaches:

Epley maneuver: The most well-known technique, involving guided head and body movements to relocate the crystals.
Home exercises: Doctors may provide simple exercises to maintain improvement.

Most patients experience relief after one or two sessions, though some may require repeated treatment or additional balance exercises, especially older adults, to reduce fall risk.

When to See a Doctor

Although BPPV itself is usually harmless, seek immediate medical attention if dizziness is accompanied by:

Severe or sudden headache
Vision loss or double vision
Hearing loss
Difficulty speaking or moving limbs
Loss of consciousness or repeated falls

These may indicate more serious health issues requiring urgent care.