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At the Center for Neurosciences, we work together across specialties to provide the best, most comprehensive approach to treatment.

Benign Paroxysmal Positional Vertigo (BPPV)

The term “vertigo” refers to the feeling that you or the outside world is spinning or tilting while in fact, you are not moving. Benign Paroxysmal Positional Vertigo (BPPV) is one of the most common causes of short-duration true vertigo. BPPV originates in the inner ear when tiny crystals called otoconia become dislodged and float into the semicircular canals. The otoconia normally provide information about gravity and motion (linear acceleration), but when they are dislodged into the balance canals, your brain receives false information from the ear about where your head is positioned in space. The vertigo typically lasts for less than a minute and begins a few seconds after moving your head into a side-tilt position. Nausea, vomiting, or nystagmus (abnormal rhythmic eye movements) may accompany the sensation of vertigo.

BPPV is triggered by a variety of activities, but changing position of the head is always involved. For example, rolling over in bed, looking up at a kitchen cabinet, and bending down while looking forward may initiate the vertigo. BPPV is most common in people over age 60, but can also occur in younger people, especially following a head injury. BPPV may be intermittent, where the symptoms last for a few days to a few weeks, disappear for a while, and then return.

Because BPPV can go away on its own, observation is one treatment option. Most commonly, however, a canalith-repositioning maneuver such as the Epley Maneuver is performed in order to move otoconia back into the place where they originated. The head is moved slowly through several positions and held in each position for about 30 seconds. Using medications to treat this type of vertigo is not recommended; however, medications to treat nausea may be prescribed as symptomatic relief. Less than 5% of BPPV patients will require surgical intervention (semicircular canal plugging) to resolve their symptoms.

Why Choose Us

  • Dr. Abraham Jacob, Medical Director for Ear & Hearing (E&H) at the Center for Neurosciences (CNS), is fellowship trained in Otology, Neurotology, and Cranial Base Surgery. He is the first and most experienced Neurotologist in Southern Arizona.
  • Dr. Jacob was a founding member of the University of Arizona (UA) Department of Otolaryngology prior to his departure and transition to CNS. At UA, he was Vice Chair of ENT and held the rank of full Professor with Tenure.
  • Dr. Jacob transitioned his practice to the Center for Neurosciences in early 2017 as he felt that the new environment helped him to optimize delivery of personalized ear and lateral skull base care.
  • Unlike most ENT physicians, Dr. Jacob’s training in Otology/Neurotology makes him the regional expert for complex surgical procedures such as semicircular canal plugging. He is able to offer this service to those patients that fail medical management with canalith-repositioning maneuvers.