Overview

Benign paroxysmal positional vertigo (BPPV) is one of the most common causes of vertigo — the sudden sensation that you're spinning or that the inside of your head is spinning.

BPPV causes brief episodes of mild to intense dizziness. It is usually triggered by specific changes in your head's position. This might occur when you tip your head up or down, when you lie down, or when you turn over or sit up in bed.

Although BPPV can be bothersome, it's rarely serious except when it increases the chance of falls. You can receive effective treatment for BPPV during a doctor's office visit.

Symptoms

The signs and symptoms of benign paroxysmal positional vertigo (BPPV) may include:

  • Dizziness
  • A sense that you or your surroundings are spinning or moving (vertigo)
  • A loss of balance or unsteadiness
  • Nausea
  • Vomiting

The signs and symptoms of BPPV can come and go and commonly last less than one minute. Episodes of BPPV can disappear for some time and then recur.

Activities that bring about the signs and symptoms of BPPV can vary from person to person, but are almost always brought on by a change in head position. Some people also feel out of balance when standing or walking.

Abnormal rhythmic eye movements usually accompany the symptoms of benign paroxysmal positional vertigo.

When to see a doctor

Generally, see your doctor if you experience any recurrent, sudden, severe, or prolonged and unexplained dizziness or vertigo.

Seek emergency care

Although it's uncommon for dizziness to signal a serious illness, see your doctor immediately if you experience dizziness or vertigo along with any of the following:

  • A new, different or severe headache
  • A fever
  • Double vision or loss of vision
  • Hearing loss
  • Trouble speaking
  • Leg or arm weakness
  • Loss of consciousness
  • Falling or difficulty walking
  • Numbness or tingling

The signs and symptoms listed above may signal a more serious problem.

From Mayo Clinic to your inbox

Sign up for free and stay up to date on research advancements, health tips, current health topics, and expertise on managing health. Click here for an email preview.

To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you. If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail.

Causes

Often, there's no known cause for BPPV. This is called idiopathic BPPV.

When there is a known cause, BPPV is often associated with a minor to severe blow to your head. Less common causes of BPPV include disorders that damage your inner ear or, rarely, damage that occurs during ear surgery or long periods positioned on your back, such as in a dentist chair. BPPV also has been associated with migraines.

The ear's role

Inside your ear is a tiny organ called the vestibular labyrinth. It includes three loop-shaped structures (semicircular canals) that contain fluid and fine, hairlike sensors that monitor your head's rotation.

Other structures (otolith organs) in your ear monitor your head's movements — up and down, right and left, back and forth — and your head's position related to gravity. These otolith organs contain crystals that make you sensitive to gravity.

For many reasons, these crystals can become dislodged. When they become dislodged, they can move into one of the semicircular canals — especially while you're lying down. This causes the semicircular canal to become sensitive to head position changes it would normally not respond to, which is what makes you feel dizzy.

Risk factors

Benign paroxysmal positional vertigo occurs most often in people age 50 and older, but can occur at any age. BPPV is also more common in women than in men. A head injury or any other disorder of the balance organs of your ear may make you more susceptible to BPPV.

Complications

Although BPPV is uncomfortable, it rarely causes complications. The dizziness of BPPV can make you unsteady, which may put you at greater risk of falling.

Aug. 05, 2022
  1. Barton JJS, et al. Benign paroxysmal positional vertigo. https://www.uptodate.com/contents/search. Accessed July 17, 2020.
  2. Elsevier Point of Care. Clinical Overview: Benign paroxysmal positional vertigo. https://www.clinicalkey.com. Accessed July 17, 2020.
  3. Ferri FF. Benign paroxysmal positional vertigo. In: Ferri's Clinical Advisor 2021. Elsevier; 2021. https://www.clinicalkey.com. Accessed July 17, 2020.
  4. Lalwani AK. Benign paroxysmal positional vertigo In: Current Diagnosis & Treatment Otolaryngology — Head & Neck Surgery. 4th ed. McGraw-Hill Education; 2020. https://accessmedicine.mhmedical.com. Accessed July 17, 2020.
  5. AskMayoExpert. Vertigo and vestibular disorders (adult). Mayo Clinic; 2020.
  6. Furman JM. Causes of vertigo. https://www.uptodate.com/contents/search. Accessed July 17, 2020.
  7. Libi SE (expert opinion). Mayo Clinic. Aug. 6, 2020.

Benign paroxysmal positional vertigo (BPPV)