Question: I am a 49 yr old female and have had Benign Positional Vertigo on and off for 38 years. Can you please recommend a specialist who can help me be rid of this curse once and for all? I’ve been to several Dr’s including an Eply therapist. Nothing has kept it from coming back. For instance, I’ve not been able to sleep on my right side for 15 mos without waking up with the room spinning. I would appreciate your feedback.
Answer: Benign positional vertigo is a specific type of imbalance. It occurs when a little hair fiber is knocked off in the fluid of the inner ear balance organ, or labyrinth. Normally, when we turn our head, fluid in the inner ear moves along little microscopic “hair” fibers in the labyrinth. This gives off an electrical current that the brain uses to determine position. If a fiber gets knocked off- perhaps from trauma or a viral infection, the fiber can float in the fluid for a few seconds after turning your head- giving off an electrical current and causing dizziness, until the fiber settles down.
With benign positional vertigo, one gets dizzy turning the head a certain direction. It is repeatable, but only lasts for a few seconds to a minute. This can be treated with the “Epley Maneuver”- a way of moving around the head to get the fiber “stuck” in a corner, so the symptoms resolve. While this tends to be quite successful (90 or so per cent of the time), it is not 100%.
Should this not work, one needs to be certain of the diagnosis- and there are other interventions that can also be recommended, depending on the severity of the symptoms.
Dr. Neil Sperling is our office is a superlative neurotologist, and specializes is issues such as these.
Frequently Asked Questions
Benign Positional Vertigo occurs when tiny hair fibers inside the fluid of the inner ear's balance organ become dislodged. These fibers float temporarily in the fluid when the head moves, sending false signals to the brain that cause dizziness or vertigo symptoms.
The Epley Maneuver involves a series of precise head movements designed to guide the dislodged hair fibers from the inner ear into a corner where they no longer trigger dizziness. This treatment is successful around 90% of the time in resolving BPV symptoms.
If the Epley Maneuver does not fully resolve your symptoms, it’s important to confirm the diagnosis since other conditions might cause similar symptoms. After confirmation, other treatment options or interventions tailored to your symptom severity can be explored by specialists.
While BPV symptoms can persist or recur, they usually last only seconds to a minute when triggered by head movement. Persistent or frequent symptoms may indicate that the fibers are not fully repositioned or that a different diagnosis should be considered, requiring specialist input.
A neurotologist is a specialist experienced in ear and balance disorders like BPV. Dr. Neil Sperling, mentioned in the content, is an example of such a specialist who can provide expert diagnosis and treatment for difficult or recurrent cases.
Symptoms worsen when lying on a specific side because the dislodged inner ear fibers move within the fluid during certain head positions. For example, sleeping on the right side may cause these fibers to float and trigger vertigo sensations due to abnormal signaling to the brain.
