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Benign Paroxysmal Positional Vertigo, Ambulatory Care

Benign paroxysmal positional vertigo (BPPV)

is an inner ear condition. With BPPV you have paroxysmal (sudden) attacks of vertigo when you change your head position. Vertigo is the sudden feeling that you or the room is moving or spinning. With each attack of vertigo, you may have nystagmus. Nystagmus is a quick, shaky eye movement that you cannot control. The attacks of vertigo and nystagmus last from a few seconds up to 1 minute.

Common symptoms include the following:

Head movements, such as looking up or down and bending over, may lead to an attack of vertigo. Vertigo may also occur when you first lie down or roll over in bed. The nystagmus will decrease with vertigo attacks that occur close together. When you have an attack of BPPV, you may also have the following symptoms:

  • Changes in your vision
  • Nausea or vomiting
  • Poor balance or feeling unsteady when you walk

Seek immediate care for the following symptoms:

  • A severe headache that does not go away
  • New changes in your vision or feeling weak or confused
  • Trouble hearing, or ringing or buzzing in your ears
  • Symptoms that last longer than 1 minute.

Treatment for BPPV

may go away on it's own. Treatments may include head movements or balance therapy. You may need surgery if other treatments have failed.

Manage your symptoms:

  • Avoid sudden head movements.
  • Do not bend over at the waist.
  • Keep your head raised when you lie down. Place pillows under your upper back and head or rest in a recliner.
  • Try not to stay in bed for long periods of time. Change your position often when you are in bed. Try not to lie with your head on the same side for long periods of time.
  • Go to vestibular and balance rehabilitation therapy (VBRT). During VBRT, you learn exercises to improve your balance and strength. VBRT may help decrease your dizziness and prevent injuries if you are at risk for falls. Ask for more information about VBRT and exercises to decrease your symptoms.

Follow up with your healthcare provider as directed:

Write down your questions so you remember to ask them during your visits.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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