Dizziness and Vertigo: Understanding BPPV and Treatment Options
Dizziness and vertigo are common symptoms that can affect people of all ages. They may cause a sensation of spinning, imbalance, light-headedness, or feeling unsteady. While these symptoms can be concerning, many cases are caused by benign conditions of the inner ear, particularly Benign Paroxysmal Positional Vertigo (BPPV).
At Niva Medical Clinic, patients can access assessment, diagnosis, and treatment for dizziness and vertigo, including the Epley manoeuvre, an evidence-based treatment for BPPV that can often provide rapid relief.
What Is Vertigo?
Vertigo is a specific type of dizziness characterised by the false sensation that you or your surroundings are spinning or moving. It commonly occurs when there is a disturbance affecting the vestibular system in the inner ear, which is responsible for maintaining balance.
Common symptoms may include:
- A spinning or rotational sensation
- Unsteadiness or loss of balance
- Nausea or vomiting
- Sensitivity to head movement
- Difficulty walking steadily
The duration of vertigo episodes can vary depending on the underlying cause.
What Is BPPV (Benign Paroxysmal Positional Vertigo)?
Benign Paroxysmal Positional Vertigo (BPPV) is one of the most common causes of vertigo seen in primary care.
It occurs when tiny calcium carbonate crystals (otoconia) in the inner ear become displaced and move into the semicircular canals. These canals help detect head movement and maintain balance. When the crystals move into the wrong position, they can send incorrect signals to the brain when the head changes position.
Typical triggers include:
- Rolling over in bed
- Looking up or bending down
- Sudden head movements
- Getting in or out of bed
Episodes usually last a few seconds to less than a minute, but they may recur frequently.
How Is BPPV Diagnosed?
BPPV is usually diagnosed through a clinical assessment and positional testing, most commonly the Dix–Hallpike test. This examination involves carefully moving the head and body in specific positions to reproduce symptoms and observe characteristic eye movements known as nystagmus.
During an appointment at Niva Medical Clinic, the GP will:
- Take a detailed history of symptoms
- Assess triggers and duration of episodes
- Perform positional examination where appropriate
- Consider and exclude other possible causes of dizziness
Most cases of BPPV can be diagnosed without the need for imaging.
Treatment for BPPV: The Epley Manoeuvre
The Epley manoeuvre is a well-established treatment designed to reposition the displaced crystals in the inner ear.
This involves a sequence of gentle head and body movements performed by a clinician to guide the crystals back to their normal location.
Key features of the treatment include:
- Non-invasive and medication-free
- Typically completed within a few minutes
- Often provides rapid symptom relief
- May occasionally require repeat treatment
The Epley manoeuvre can be performed during a consultation at Niva Medical Clinic, allowing many patients to experience improvement in symptoms soon after treatment.
When Should You Seek Medical Advice for Dizziness?
Although many cases of vertigo are benign, it is important to seek medical assessment if symptoms are persistent or unusual.
Medical advice should be sought if dizziness occurs with:
- Severe or persistent headache
- Double vision or difficulty speaking
- Weakness or numbness
- Difficulty walking
- Hearing loss or ringing in the ears
A clinical assessment helps determine the cause and ensure appropriate management.
Vertigo Assessment in Stanmore and North-West London
Patients experiencing dizziness or vertigo can access assessment and treatment at Niva Medical Clinic.
The clinic provides care for patients across:
- Stanmore
- Harrow
- Edgware
- Bushey
- Watford
- Northwood
- Hatch End
- Wembley
- Barnet
With same-day GP appointments available, patients can receive prompt evaluation and treatment for vertigo symptoms.
Frequently Asked Questions (FAQs) – Vertigo and BPPV
What is the most common cause of vertigo?
One of the most common causes of vertigo is Benign Paroxysmal Positional Vertigo (BPPV). It occurs when small calcium crystals in the inner ear become displaced and trigger brief spinning sensations during head movements.
How long does BPPV last?
Episodes of BPPV usually last seconds to less than a minute, but symptoms can recur over several days or weeks. With treatment such as the Epley manoeuvre, symptoms often improve quickly.
What is the Epley manoeuvre?
The Epley manoeuvre is a series of specific head movements used to reposition displaced crystals in the inner ear that cause BPPV. It is a safe and effective treatment commonly performed in clinic.
Can BPPV go away on its own?
BPPV can sometimes resolve spontaneously over time. However, treatment with repositioning manoeuvres such as the Epley manoeuvre can significantly shorten recovery and reduce symptoms.
Where can I get vertigo treatment near Stanmore?
Patients experiencing dizziness or vertigo can be assessed at Niva Medical Clinic, where GPs can diagnose BPPV and perform the Epley manoeuvre when appropriate.
Is dizziness always caused by an inner ear problem?
No. Dizziness can have several causes including inner ear conditions, blood pressure changes, migraine, medication side effects, anxiety, or neurological disorders. Medical assessment helps identify the underlying cause.
Do I need a scan for vertigo?
Most cases of BPPV can be diagnosed clinically without imaging. Scans are generally only recommended if symptoms suggest another neurological condition.
Additional FAQs
How do you treat vertigo quickly?
For vertigo caused by BPPV, repositioning manoeuvres such as the Epley manoeuvre are often the most effective treatment. Many patients experience improvement shortly after the procedure.
What triggers BPPV vertigo?
Common triggers include turning in bed, looking upwards, bending down, or sudden head movements. These positional changes move displaced crystals within the inner ear and trigger vertigo.
Can a GP treat vertigo?
Yes. Many cases of vertigo, particularly BPPV, can be diagnosed and treated by a GP using positional tests and manoeuvres such as the Epley manoeuvre.
Evidence-Based References and Guidance
NICE Clinical Knowledge Summary – Benign Paroxysmal Positional Vertigo (BPPV)
Full clinical guidance for primary care assessment and management of BPPV.
Link:
https://cks.nice.org.uk/topics/benign-paroxysmal-positional-vertigo/
NICE guidance explains that BPPV presents with brief episodes of vertigo triggered by head movement and can often be treated using particle repositioning manoeuvres such as the Epley manoeuvre.
NICE Quality Standard – Assessment for BPPV
Guidance on diagnosing BPPV using positional testing such as the Dix–Hallpike manoeuvre.
Link:
https://www.nice.org.uk/guidance/qs198/chapter/Quality-statement-4-Hallpike-manoeuvre-for-adults
NICE recommends that adults with vertigo triggered by head movement should be assessed using the Hallpike manoeuvre, which helps confirm BPPV and guide treatment.
NHS Guidance – Vertigo and Inner Ear Conditions
Patient guidance on dizziness and vestibular disorders.
Link:
https://www.nhs.uk/conditions/labyrinthitis/
The NHS explains that vertigo can cause spinning sensations, nausea, and balance problems, often related to conditions affecting the inner ear balance system.
Mayo Clinic – Diagnosis and Treatment of BPPV
Overview of BPPV and repositioning treatments such as the Epley manoeuvre.
Link:
https://www.mayoclinic.org/diseases-conditions/vertigo/diagnosis-treatment/drc-20370060
The canalith repositioning procedure involves simple head movements to move displaced inner ear crystals back to their normal location, often relieving symptoms after one or two treatments.
StatPearls Clinical Review – BPPV Management
Evidence-based overview of BPPV treatment.
Link:
https://www.ncbi.nlm.nih.gov/books/NBK470308/
Clinical reviews confirm that the primary treatment for BPPV is canalith repositioning manoeuvres, including the Epley manoeuvre, which reposition displaced calcium crystals in the inner ear.
RCGP Educational Resource – BPPV Management
Primary care guidance on performing repositioning manoeuvres.
Link:
https://elearning.rcgp.org.uk/mod/book/view.php?id=12532
The RCGP notes that canalith repositioning procedures such as the Epley manoeuvre are highly effective treatments used by trained clinicians to reposition displaced otoconia
