Vestibular Rehabilitation – Benign Paroxysmal Positional Ver

---

Benign Paroxysmal Positional Vertigo (BPPV) is the most common cause of vertigo, triggered when tiny calcium crystals (otoconia) inside the inner ear become displaced. These crystals migrate into one of the semicircular canals, disrupting normal balance signals and causing sudden spinning sensations.

BPPV is mechanical, not neurological, meaning it responds extremely well to physiotherapy through repositioning maneuvers that guide the crystals back to their proper location.

• Age‑related changes in the inner ear
• Head trauma or whiplash
• Prolonged positioning (dental work, hair salon sinks)
• Viral inner‑ear infections
• Degeneration of vestibular structures
• Idiopathic (no clear cause)

Once crystals become displaced, certain head movements trigger vertigo episodes.

• Sudden spinning sensation lasting seconds to minutes
• Vertigo triggered by rolling in bed, looking up, bending forward, or turning quickly
• Nausea or imbalance
• A feeling of being “pulled” in a direction
• Brief episodes that repeat with specific movements
• No hearing loss or ringing (distinguishes BPPV from other vestibular disorders)

Symptoms may come and go but often persist without proper treatment.

• Canalith repositioning maneuvers (Epley, Semont, Gufoni, BBQ roll)
• Vestibular rehabilitation for balance and gaze stability
• Cervical spine assessment when neck involvement contributes to symptoms
• Habituation exercises for residual dizziness
• Biomechanics analysis to identify movement triggers
• Education on safe movement, sleeping positions, and recurrence prevention

Most cases resolve within 1–3 physiotherapy sessions.

Your physiotherapist will perform:

• Dix‑Hallpike and roll tests to identify the affected canal
• Eye movement (nystagmus) observation to confirm diagnosis
• Balance and gait assessment
• Cervical spine mobility testing
• Screening for non‑BPPV vestibular conditions
• A personalized treatment plan based on the canal involved and symptom severity

Book an assessment if you experience:

• Vertigo triggered by rolling in bed or looking up
• Sudden spinning episodes lasting seconds
• Imbalance or nausea with head movement
• Recurring vertigo after previous BPPV treatment
• Dizziness following a concussion or whiplash

Prompt treatment prevents falls, reduces anxiety, and restores confidence in movement.