Benign Positional Vertigo

What is Benign Positional Vertigo

Vertigo is the feeling that you or your surroundings are moving when they are not. Benign positional vertigo is the most common form of vertigo. The cause of this condition is not serious (is benign).

This condition is triggered by certain movements and positions (is positional). This condition can be dangerous if it occurs while you are doing something that could endanger you or others, such as driving.

5 Interesting Facts of Benign Positional Vertigo

  1. Vertigo that is brought on by quick head movement in the nonaxial plane (eg, rolling over in bed, looking up at an object)
  2. Patient may feel nauseous, unsteady, and scared
  3. Symptoms typically resolve within seconds (less than 1 minute)
  4. Motion testing causes symptoms of vertigo
  5. Differentiated by absence of hearing loss and by elicitation of nystagmus with Dix Hallpike maneuver

What are the causes?

In many cases, the cause of this condition is not known. It may be caused by a disturbance in an area of the inner ear that helps your brain to sense movement and balance. This disturbance can be caused by a viral infection (labyrinthitis), head injury, or repetitive motion.

What increases the risk?

This condition is more likely to develop in:

  • Women.
  • People who are 50 years of age or older.

What are the symptoms of Benign Positional Vertigo?

Symptoms of this condition usually happen when you move your head or your eyes in different directions. Symptoms may start suddenly, and they usually last for less than a minute. Symptoms may include:

  • Loss of balance and falling.
  • Feeling like you are spinning or moving.
  • Feeling like your surroundings are spinning or moving.
  • Nausea and vomiting.
  • Blurred vision.
  • Dizziness.
  • Involuntary eye movement (nystagmus).

Symptoms can be mild and cause only slight annoyance, or they can be severe and interfere with daily life. Episodes of benign positional vertigo may return (recur) over time, and they may be triggered by certain movements. Symptoms may improve over time.

How is Benign Positional Vertigo diagnosed?

This condition is usually diagnosed by medical history and a physical exam of the head, neck, and ears. You may be referred to a health care provider who specializes in ear, nose, and throat (ENT) problems (otolaryngologist) or a provider who specializes in disorders of the nervous system (neurologist). You may have additional testing, including:

  • MRI.
  • A CT scan.
  • Eye movement tests. Your health care provider may ask you to change positions quickly while he or she watches you for symptoms of benign positional vertigo, such as nystagmus. Eye movement may be tested with an electronystagmogram (ENG), caloric stimulation, the Dix-Hallpike test, or the roll test.
  • An electroencephalogram (EEG). This records electrical activity in your brain.
  • Hearing tests.

How is Benign Positional Vertigo treated?

Usually, your health care provider will treat this by moving your head in specific positions to adjust your inner ear back to normal. Surgery may be needed in severe cases, but this is rare. In some cases, benign positional vertigo may resolve on its own in 2-4 weeks.

Follow these instructions at home:


  • Move slowly.Avoid sudden body or head movements.
  • Avoid driving.
  • Avoid operating heavy machinery.
  • Avoid doing any tasks that would be dangerous to you or others if a vertigo episode would occur.
  • If you have trouble walking or keeping your balance, try using a cane for stability. If you feel dizzy or unstable, sit down right away.
  • Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.

General instructions

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Avoid certain positions or movements as told by your health care provider.
  • Drink enough fluid to keep your urine clear or pale yellow.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • You have a fever.
  • Your condition gets worse or you develop new symptoms.
  • Your family or friends notice any behavioral changes.
  • Your nausea or vomiting gets worse.
  • You have numbness or a “pins and needles” sensation.

Get help right away if:

  • You have difficulty speaking or moving.
  • You are always dizzy.
  • You faint.
  • You develop severe headaches.
  • You have weakness in your legs or arms.
  • You have changes in your hearing or vision.
  • You develop a stiff neck.
  • You develop sensitivity to light.

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