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Vestibular Rehabilitation

What is BPPV?

Benign Paroxysmal Positional Vertigo is the most common cause of vertigo symptoms. It is caused by displacement of the calcium carbonate crystals from the organs of the inner ear that detect acceleration and deceleration to the pitch, roll and yaw organs. This causes a false sense of movement that can range from mild or violent.


Symptoms *Remember symptoms can range from very mild to violent*

  • Vertigo
  • Feeling faint
  • Light-headiness
  • Feeling the room spin
  • Visual disturbance
  • Unsteadiness
  • Weakness
  • Wooziness
  • Fatigue
  • Nausea

Epidemiology & Causes

Estimates of prevalence of this disorder vary:

  • 7% life time incidence with 50% of those experiencing recurrence in 5 years
  • Most common diagnosis by family practitioners for symptom of vertigo
  • New concerns of under-diagnosis in the senior population

Causes are not clearly understood but BPPV is correlated with:

  • Head trauma and whiplash
  • Other inner ear dysfunction: Meniere’s Disease, Vestibular Neuronitis & Labyrinthitis
  • Aging inner ear: increased incidence over 65
  • Postmenopausal women

Treatment Options

Literature reviews indicate self-resolution of symptoms in 16-39 days depending on the location of the debris in client’s with only 1 affected area. A variety of medications can be used temporarily to manage symptoms and associated fall risk. Repositioning maneuvers are successful in over 90% of client’s experiencing BPPV. If needed re-education of the vestibular system and balance strategies to decrease fear of falling.

Preparations for your first visit:

  • Try to arrange a driver for your initial evaluation
  • Discuss holding your vertigo medication the day of your evaluation with your doctor
  • Bring any vertigo medications with you to your evaluation
  • Wear comfortable clothes and good walking shoes
  • Plan to be able to go home and rest afterwards
  • Plan on 2-3 follow up visits