Benign paroxysmal positional vertigo is a common but highly annoying form of vertigo. A change in position can cause you to feel as if the environment around you is spinning when it is stationary. Nausea and vomiting can accompany the spinning feeling.

This vertigo is episodic. That means it comes on suddenly and is over as quickly as it begins. It can happen when you stand up, turn your head or even when you get out of bed in the morning.

Causes of benign paroxysmal positional vertigo

This form of vertigo is caused by a problem in the labyrinth system in the inner ear. This portion of the ear is responsible for balance. The labyrinth system is made up of three semicircular canals with nerves and fluid that act like an internal gyroscope. They tell the brain where the body is in relation to gravity.

Little granules, known as canaliths sit on top of the nerves. Benign paroxysmal positional vertigo happens when these little granules wander from their position on top of the nerves. They may fall off the nerve endings and travel to other areas of the labyrinth system where they cause problems. They can cause canals that are not involved in determining head position to become sensitive to head position. This is confusing to the brain. These loose canaliths can also cause changes to the fluid in the ear.

Canaliths can be dislodged by minor head injuries, repetitive shaking of the head, viral infection or nerve inflammation. Sometimes the cause is never identified. However, the ENT can still treat the vertigo successfully.

How ENTs treat benign paroxysmal positional vertigo

In order to stop the vertigo the ENT must get those canaliths back where they belong! There are several different canalith repositioning procedures that the ENT can perform in the office to reposition the roaming granules.

These therapies (most commonly the Epley maneuver) are a series of maneuvers to the head, neck and body that move the canaliths back into position. They can be performed in the ENT’s office and should take no more than 15-20 minutes. The procedure can cause severe nausea so the ENT might give you medication in advance to reduce this side effect. The medication can be given orally in advance of treatment or intravenously during treatment.

During the procedure, the ENT will reposition your body, head and neck while observing the eyes for nystagmus (involuntary eye movements). Sometimes only one treatment in the office is necessary. A modified Epley maneuver can be performed at home and the ENT may give you instruction and directions to repeat these maneuvers at home. If necessary, you may need to come back to the ENT’s office for an additional professional Epley maneuver.

If you are experiencing episodes of dizziness or vertigo, contact the ENT for evaluation and treatment. Since balance begins in the ears, the ENT is the most qualified medical professional to treat balance disorders such as vertigo.