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Treatments and drugs
By Mayo Clinic staffTo help relieve benign paroxysmal positional vertigo (BPPV), your doctor, audiologist or physical therapist may treat you with a series of movements known as the canalith repositioning procedure.
Canalith repositioning
Performed in your doctor's office, the canalith repositioning procedure consists of several simple and slow maneuvers for positioning your head. The goal is to move particles from the fluid-filled semicircular canals of your inner ear into a tiny bag-like open area (vestibule) that houses one of the otolith organs (utricle) in your ear where these particles don't cause trouble and are more easily reabsorbed. Each position is held for about 30 seconds after any symptoms or abnormal eye movements stop. This procedure is usually effective after one or two treatments.
After the procedure, you must avoid lying flat or placing the treated ear below shoulder level for the rest of that day. For the first night following the procedure, you should elevate your head on a few pillows when you sleep. This allows time for the particles floating in your labyrinth to settle into your vestibule and be reabsorbed by the fluids in your inner ear.
On the morning after your in-office procedure, your restrictions will be lifted and you'll begin self-care as directed by your doctor. Your doctor likely will have taught you how to perform the canalith repositioning procedure on yourself so that you can do it at home before returning to the office for a recheck.
Surgical alternative
In rare situations in which the canalith repositioning procedure isn't effective, your doctor may recommend a surgical procedure in which a bone plug is used to block the portion of your inner ear that's causing dizziness. The plug prevents the semicircular canal in your ear from being able to respond to particle movements or head movements in general. This success rate for canal plugging surgery is greater than 90 percent.
- Benign paroxysmal positional vertigo (BPPV). Vestibular Disorders Association. http://www.vestibular.org/vestibular-disorders/specific-disorders/bppv.php. Accessed April 7, 2010.
- Barton J. Benign paroxysmal positional vertigo (BPPV). http://www.uptodate.com/home/index.html. Accessed April 7, 2010.
- Benign paroxysmal positional vertigo. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec08/ch086/ch086c.html. Accessed April 7, 2010.
- Benign paroxysmal positional vertigo (BPPV). American Hearing Association. http://www.american-hearing.org/disorders/benign-paroxysmal-positional-vertigobppv/. Accessed April 7, 2010.
- Fife TD, et al. Practice parameter: Therapies for benign paroxysmal positional vertigo (an evidence-based review). American Academy of Neurology. http://www.aan.com/practice/guideline/uploads/351.pdf. Accessed April 7, 2010.
- Shephard NT (expert opinion). Mayo Clinic, Rochester, Minn. April 9, 2010.
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