Balance and Vestibular Program

Benign Paroxysmal Positional Vertigo (BPPV)

Overview

Benign Paroxysmal Positional Vertigo (BPPV) causes recurring, brief episodes of vertigo, meaning the child feels a sensation that the world around her is spinning.

These episodes, typically lasting a few seconds to minutes, are usually prompted by lying down, rolling over in bed, turning the head or similar movements. BPPV results from displacement of crystals called otoliths in the balance organs of the inner ear. These crystals normally rest on a jelly-like structure called the macula. A minor head injury can cause these crystals to dislodge from the macula and move around in the inner ear.

Turning the head can also cause the dislodged crystals to stimulate another part of the inner ear called the posterior semicircular canal. This results in the sensation of vertigo. 

How Boston Children's Hospital approaches BPPV

We diagnose BPPV with a test called the Dix-Hallpike maneuver. For this test, your child's doctor will move her quickly from a sitting to a lying-down position while she wears special glasses capable of detecting the subtle eye movements that are typical of the disorder.

BPPV usually resolves on its own after a few weeks, even without treatment. It can also be successfully treated by the Epley maneuver. In this maneuver, the doctor moves the child into a series of positions, attempting to move the displaced crystals in the inner ear back into their proper position.