Benign Paroxysmal Positional Vertigo (BPPV): Care Instructions

How can you care for yourself at home?

Benign paroxysmal positional vertigo, also called BPPV, is an inner ear problem. It causes a spinning or whirling sensation when you move your head. This sensation is called vertigo.

The vertigo usually lasts for less than a minute. People often have vertigo spells for a few days or weeks. Then the vertigo goes away. But it may come back again. The vertigo may also cause unsteadiness, nausea, and vomiting. You may be at risk for falls.

When you move, your inner ear sends messages to the brain. This helps you keep your balance. Vertigo can happen when tiny calcium "stones" move into an area of your inner ear called the semicircular canal. This can cause the inner ear to send the wrong message to the brain.

Your doctor may move you in different positions to help your vertigo get better faster. This is called the Epley maneuver. Your doctor may also prescribe exercises for you to do on your own.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Vertigo causes loss of balance and puts you at risk for falling. Be extra careful so that you don't hurt yourself or someone else if you have a sudden attack of vertigo.

• Don't drive or ride a bike if you are having vertigo.
• Keep floors and walkways free of clutter so you don't trip.
• Avoid heights.

Your doctor may suggest that you do the Epley maneuver at home. Here's how:

1. Sit on the edge of a bed. Give yourself enough room to roll onto your side in the direction the doctor told you to. Place a pillow on the bed behind you so that when you lie down the pillow is under your shoulders and your head can tilt back.
2. Turn your head about halfway (45 degrees) toward the ear that causes the most vertigo for you.
3. Quickly tilt yourself backward until you are lying on your back with the pillow under your shoulders. Your head will tilt back off the pillow. Your head should be about midway between looking straight up and looking out to your side. Hold for at least 20 seconds. Your doctor may tell you to stay in this position until any vertigo stops.
4. Turn your head halfway to the other side (about 45 degrees). This will be the side that has the least vertigo. Hold for at least 20 seconds or until your doctor says you should stop.
5. Keeping your head turned about halfway toward your shoulder, roll onto the side that causes the least vertigo. Your face should now be pointing toward the floor. Hold for at least 20 seconds. Then slowly push yourself up to a sitting position. Your doctor may have you repeat the whole series of movements until the vertigo is gone.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

• You passed out (lost consciousness).
• You have sudden dizziness that doesn't get better.
• You have dizziness along with symptoms of a heart attack. These may include:
  • Chest pain or pressure, or a strange feeling in the chest.
  • Sweating.
  • Shortness of breath.
  • Nausea or vomiting.
  • Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly or in one or both shoulders or arms.
  • Lightheadedness or sudden weakness.
  • A fast or irregular heartbeat.
• You have symptoms of a stroke. These may include:
  • Sudden numbness, tingling, weakness, or loss of movement in your face, arm, or leg, especially on only one side of your body.
  • Sudden vision changes.
  • Sudden trouble speaking.
  • Sudden confusion or trouble understanding simple statements.
  • Sudden problems with walking or balance.
  • A sudden, severe headache that is different from past headaches.

Call your doctor now or seek immediate medical care if:

• You have new or worse nausea and vomiting.
• You have new symptoms such as a fever, a headache, hearing loss, or ringing in your ears.

Watch closely for changes in your health, and be sure to contact your doctor if:

• You are not getting better as expected.