Vertigo (BPPV)
Brief spinning episodes triggered by head movement — Epley manoeuvre treatment.
Overview
Vertigo, specifically Benign Paroxysmal Positional Vertigo (BPPV), is one of the most common causes of dizziness seen in our neurology OPD at Sanjeevi Hospital. It occurs when tiny calcium crystals in your inner ear, which help control balance, shift out of their normal place and move into the fluid-filled canals. In India, factors such as vitamin D deficiency, age-related changes, or minor head knocks often contribute to this condition. Patients describe it as a sudden sensation that the room is spinning or tilting, usually triggered by simple actions like turning in bed or looking up at a high shelf. While the spinning sensation is brief, usually lasting less than a minute, it can be quite distressing and increase the risk of falls. At Sanjeevi Hospital, we focus on providing a clear diagnosis and gentle physical maneuvers to reposition these crystals, helping you regain your balance and confidence in your daily movements.
Symptoms to watch for
- A sudden sensation that you or your surroundings are spinning (vertigo)
- Dizziness or lightheadedness when changing positions
- Loss of balance while standing or walking
- Nausea or a 'queasy' feeling in the stomach
- Vomiting in severe episodes of spinning
- Nystagmus, which is abnormal or jerking eye movements
- Blurred vision during the dizzy spells
- A feeling of instability that lasts after the spin stops
- Symptoms triggered by tilting the head, rolling over, or sitting up
Causes & risk factors
- Dislodged calcium carbonate crystals (otoconia) in the inner ear
- Natural age-related wear and tear of the vestibular system
- Minor to severe head injuries or bumps to the skull
- Inner ear infections or inflammatory conditions
- Prolonged periods of bed rest or lying in one position
- Complications from ear surgery
- Migraine-associated vertigo patterns
- Vitamin D deficiency, which may affect crystal stability
Diagnosis
- Dix-Hallpike Test: A diagnostic movement where the doctor observes eye movements while moving your head
- Supine Roll Test: Used to check for crystals in the horizontal ear canals
- Physical Examination of balance and gait
- Electronystagmography (ENG) or Videonystagmography (VNG) to record eye movements
- MRI scans to rule out other neurological causes of dizziness
- Hearing tests (Audiometry) to check for inner ear involvement
- Blood tests to check for vitamin levels and signs of infection
Treatment options
Epley Manoeuvre
A series of specific head and body movements performed by our specialists to move the crystals back to their rightful chamber in the inner ear.
Semont Manoeuvre
A rapid movement technique where the patient is moved from side-lying on one side to the other to clear the ear canals.
Vestibular Rehabilitation Therapy (VRT)
A specialized exercise program designed to retrain the brain to compensate for inner ear imbalances and improve overall stability.
Brandt-Daroff Exercises
Simple movements that patients can be taught to perform safely at home to help habituate the brain to dizzy triggers.
Anti-vertigo Medications
Short-term use of mild 'vestibular suppressants' to control acute nausea and severe spinning sensations during the initial phase.
Vitamin D and Calcium Supplementation
Correcting underlying nutritional deficiencies that may be making the crystals more likely to become loose.
Surgical Options
In very rare, chronic cases that do not respond to physical therapy, a surgical plug may be used to block the affected canal.
Hydration and Electrolyte Management
Ensuring proper fluid balance to maintain the health of the endolymph fluid within the inner ear structures.
When to see a doctor
While BPPV is rarely serious, vertigo can sometimes indicate other health issues. Please seek immediate medical attention at Sanjeevi Hospital if your dizziness is accompanied by a sudden, severe headache, high fever, double vision or loss of vision, hearing loss, difficulty speaking, or weakness in your arms or legs. If you experience a fainting spell or have trouble walking, our emergency team is here to help you 24/7. We understand how frightening balance issues can be, and we are committed to finding the cause with empathy and care.
Prevention & self-care
- Avoid sudden or extreme head movements whenever possible
- Use two or more pillows to keep your head slightly elevated while sleeping
- Properly treat any ear infections or sinus issues promptly
- Take extra care when bending down or reaching for high objects
- Incorporate balance exercises like Yoga or Tai Chi into your routine
- Ensure adequate intake of Vitamin D through sunlight and diet
- Stay well-hydrated, especially during the hot Sangareddy summers
- Sit down immediately if you start to feel dizzy to prevent falls
Related conditions
Migraine & Headache
Throbbing headaches, aura and triggers — preventive and acute treatment.
Stroke
Sudden weakness or speech loss — recognise FAST symptoms and act fast.
Epilepsy & Seizures
Long-term seizure control with the right anti-epileptic medication.
Peripheral Neuropathy
Numbness and tingling in feet — diabetic and other causes.
Answers about Vertigo (BPPV)
Common questions about Vertigo (BPPV) — diagnosis, treatment and recovery at Sanjeevi Hospital, Sangareddy.