Positional Vertigo, also known as "Benign Positional Vertigo", "Benign Paroxysmal Positional Vertigo" or "BPPV", is caused by tiny calcium particles that have broken free from the balance detectors in the inner ear and are floating in the inner ear fluid. These "floaters" become trapped in the balance canals of the inner ear and cause them to become overly sensitive to head movements. They cause a spinning sensation (vertigo) that is brought on by head movements or changes in position and typically lasts for several seconds. The spinning dizziness is especially noticeable when the head is turned in a particular direction, such as when getting out of bed in the morning or rolling over in bed. The vertigo usually subsides as the crystals settle to the bottom of the inner ear from gravity but the feeling of being off balance or light headed may persist. The dizzy spells of Positional Vertigo may be debilitating and are sometimes accompanied by blurred vision, nausea and vomiting. In an attempt to minimize the frequency and severity of the dizzy spells we recommend that you sleep with your head elevated by two pillows, avoid lying on the side that provokes the dizziness, come out of bed slowly, and try to recognize and avoid specific movements that precede the dizzy spells.

Positional Vertigo may be treated with repositioning maneuvers and exercises, such as Semont Exercises, in which the head is held in a series of different positions to allow the floaters to fall out of the balance canal to another part of the inner ear to lessen their effect. Additionally, Balance Exercises and Vestibular Rehabilitation (physical therapy for the balance system) may be helpful in reducing the dizziness and effects of Positional Vertigo.

If medical treatment and balance exercises do not provide relief from the vertigo, a procedure called Inner Ear Perfusion can help reduce or eliminate the dizziness.

Perfusion of the Inner Ear with Streptomycin/Dexamethasone reduces the sensitivity of the balance receptors in the inner ear so that the patient's dizzy spells are greatly reduced even though the "floaters" may still be there. Inner Ear Perfusion is easily performed as a simple outpatient procedure in which a small amount of medication is injected through a tiny hole in the ear drum into the middle ear space once daily for three consecutive days.