Benign paroxysmal positional vertigo (BPPV)
BPPV causes repeated brief spinning episodes with changes in head position, such as turning in bed or looking up. Similar symptoms can have other causes, so an examination is needed.
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Why it happens
Small inner-ear crystals can move into a semicircular canal and cause vertigo as the head moves. Typical episodes last seconds to tens of seconds and usually do not cause tinnitus or hearing loss. Other patterns need assessment for other causes.
When to seek care
Consult ENT for repeated positional vertigo, troublesome nausea or risk of falls. Sudden hearing loss requires prompt assessment. Severe headache, weakness, speech difficulty, sudden inability to stand or altered consciousness needs emergency evaluation.
Assessment
We review provoking positions, duration, hearing changes, headache and medicines, then examine the ears and eye movements and consider necessary tests. Atypical, persistent or neurological findings may require evaluation elsewhere.
Treatment and daily safety
After diagnosis, canalith repositioning manoeuvres may be considered according to the affected canal and the patient’s neck and back condition. Seek diagnosis and instruction before trying exercises from videos. Take precautions against falls and avoid driving while dizzy; recurrence should be reassessed.
Frequently asked questions
Is this the same as lightheadedness on standing?
Typical BPPV causes brief spinning with head position. Dimming vision on standing may involve blood pressure or other causes. Symptoms alone are not enough to distinguish them.
Can it recur?
Yes. Recurrent or changed symptoms, particularly with hearing changes, should be reassessed.
Related guides
Visiting Honda ENT Clinic
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About this information
Published by Honda ENT Clinic. Content management: Medical Director Dr. Yusuke Honda. Reference checking and editing: website administration. Checked and updated: 15 October 2026.
This is general information; individual diagnosis and treatment depend on clinical assessment.