Benign Paroxysmal Positional Vertigo (BPPV): Treatment Overview

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Treatment Overview

Benign paroxysmal positional vertigo (BPPV) may go away in a few weeks by itself. If treatment is needed, it usually consists of head exercises (Semont and Epley maneuvers). These exercises will move the particles out of the semicircular canals of your inner ear to a place where they will not affect your balance.

Over time, your brain may react less and less to the confusing signals triggered by the particles in the inner ear. This is called compensation. Compensation occurs most quickly if you continue normal head movements, even though doing so causes the whirling sensation of vertigo. A Brandt-Daroff exercise may also be done to speed the compensation process. This exercise takes you from sitting to lying on the side that causes the worst vertigo. You'll remain in this position until either the vertigo goes away or until 30 seconds have passed. This movement is then repeated on the other side. These exercises are done twice a day for several weeks to months, or until the vertigo goes away.

Medicines called vestibular suppressants (such as antihistamines, sedatives, or scopolamine) reduce vertigo and may be tried if your symptoms are severe. However, using medications to control vertigo often extends the time needed for compensation to occur.

Antiemetic medications may also be used to reduce nausea and vomiting that can occur with vertigo.

In rare cases, surgery may be used to treat BPPV.

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Last updated:	January 29, 2007
Author:	Kathe Gallagher, MSW
Reviewed By:	Anne C. Poinier, MD - Internal Medicine, Barrie J. Hurwitz, MD - Neurology
Editors:	Kathleen M. Ariss, MS, Pat Truman