Vertigo :: Repositioning treatment stops the spin for the most common form of vertigo

Vertigo is the medical term for when it seems the world is spinning on its side. It merits a trip to the doctor.

A series of tests can help determine the cause. For many people, the diagnosis will be benign paroxysmal positional vertigo (BPPV) — a common form that is generally treatable with a simple in-office procedure.

The July issue of Mayo Clinic Health Letter provides an overview of BPPV. What sets things spinning is the displacement of tiny particles called otoconia (o-toe-KOE-nee-uh) in the inner ear. Normally, these particles are attached to sensors that help detect gravity and straight-line motion. If these particles are loose, they end up floating in the fluid of the semicircular canals in the inner ear. This can occur in adults of any age although it’s increasingly common after age 50. Why it develops isn’t clear, but one instance when it can occur is after a blow to the head.

Certain positions or movements, such as rolling over in bed, sitting up, looking up or bending forward can set the otoconia in motion. The result is a false sense of movement — a sudden short spinning sensation, usually lasting less than a minute. Without treatment, bouts of vertigo due to BPPV may occur off and on unpredictably for weeks or even years.

Fortunately, a series of repositioning maneuvers with the head can direct the loose otoconia particles back where they won’t interfere with balance. A physician or a physical therapist can guide the movements, and it may be necessary to do these maneuvers several times. When properly performed, the repositioning procedure typically has a success rate of 80 percent to 90 percent.


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