Health AssessmentHeath and WellnessPhysiotherapy

What Is Benign Paroxysmal Positional Vertigo?


By: Himja Upadhyay, Registered Physiotherapist

Benign Paroxysmal Positional Vertigo (BPPV) is the most common form of positional vertigo and it is mostly the cause for nearly half of all people with a peripheral vestibular system dysfunction.

The prevalence of BPPV in the general population is thought to be 2.4%, but the prevalence increases with age. It is seven times more common in people over age 60 compared to people who are age 18 to 39. In people over the age of 65, the incidence may be as high as 35% to 40%.

Symptoms of dizziness or spinning increase with looking up/down, bending forward, and lying/rolling in bed. It is most easily treated with physiotherapy maneuvers.

What Are the Causes?

  • Idiopathic or unknown cause
  • Head trauma
  • Whiplash injuries
  • Labyrinthitis
  • Neuritis
  • Ischemia or reduction of blood supply
  • Migraines

What Exactly Happens in BPPV?


The inner ear has fluid-filled tubes called semicircular canals. When you move, the fluid moves inside these tubes. The canals are very sensitive to any movement of the fluid. The sensation of the fluid moving in the tube tells your brain the position of your body. This helps you keep your balance.

BPPV occurs when a small piece of bone-like calcium (located in the saccule and utricle of your inner ear) breaks and floats inside the tube. This sends confusing messages to your brain about your body’s position.

Exams and Tests

To diagnose BPPV, a test is performed that is called the Dix-Hallpike maneuver and Head Roll test. As you do these tests, your therapist will look for abnormal eye movements and ask if you feel like you are spinning.

The therapist will do a detailed subjective and clinical exam to determine the cause of your problem and rule out other causes.

BPPV Treatment

Your provider will do a procedure called Epley’s maneuver. It can move the small piece of calcium that is floating inside your inner ear. This treatment works best to cure BPPV.

Other treatment options include: home-based exercise therapy, surgery, medication, or simply coping with the symptoms while waiting for them to resolve.


BPPV is uncomfortable, but it can usually be treated with Epley’s maneuver. It may come back again without warning.

>> Please contact our clinic at 905 456 8196 to get more information about vestibular rehabilitation therapy, or book an appointment today!

Like this? You might also like: