BPPV: Overview

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Dizziness can be described in many ways

  • Unsteady, poor balance
  • Lightheaded
  • Spinning or motion sensation
  • Vague spatial disorientation symptoms
  • Floating sensation
  • Foggy

Vertigo is the sensation of motion, but you are not moving. It is a symptom, not a diagnosis. Vertigo is often a spinning type sensation. Associated nausea and vomiting are common.

Vertigo causes include:

  • benign paroxysmal positional vertigo
  • vestibular neuritis
  • Ménière’s disease
  • motion intolerance
  • central vestibular dysfunction
  • peripheral vestibulopathy
  • infective labyrinthitis
  • vestibular migraine
  • otologic surgery
  • otosclerosis
  • vertebrobasilar insufficiency
  • cardiovascular dysfunction
  • medication side effect
  • head injury
  • cerebellopontine tumors or vascular lesions
  • cervical vertigo
  • anxiety disorders
  • idiopathic (unknown cause)

Unsteadiness causes include:

  • medication side effect
  • peripheral or central vestibular abnormality
  • central nervous system lesion
  • acute/chronic otitis media
  • head injury
  • perilymph fistula
  • hyperventilation
  • functional (non-organic)

Lightheadedness causes include:

  • medication side effect
  • cardiovascular problem
  • central nervous system lesion
  • metabolic
  • anxiety
  • systemic etiology

Diagnosis of Vertigo Based on Duration of Symptoms


Minutes to Hours

Many Hours to Days

Benign paroxysmal positional vertigo Menier’s disease Neuronitis
Superior canal dehiscence Migraine-associated vertigo Trauma
Uncompensated weakness Transient ischemic attack Multiple sclerosis
Transient ischemic attack Autoimmune disorder Benign intracranial hypertension
Panic Attack Autoimmune disorder
Metabolic disorder Iatrogenic disease
Iatrogenic disease

Kaylie, D., D. Garrison, et al. (2012). “Evaluation of the patient with recurrent vertigo.” Archives of otolaryngology–head & neck surgery 138(6): 584-587.

Symptoms of Dizziness Due to Aging

You may notice a lightheadedness, spinning sensation, giddiness, wooziness or unsteadiness that occurs when quickly turning or changing positions, when bending over and returning to an upright position or when looking up or down. These symptoms last for a short time. You may notice a tendency to sway or veer from side to side when walking.

Vertigo / Dizziness Evaluation and Treatment:

Accurate diagnosis is very important. This requires a complete history and physical examination. Audiologic testing is often needed. Other potential tests include CT scan. MRI, ENG -vestibular testing and blood work. Dizziness treatment is then tailored to the specific problem.

If you have vertigo problems, please call 503-257-3204 or request a visit online with us.


Kaylie, D., D. Garrison, et al. (2012). “Evaluation of the patient with recurrent vertigo.” Archives of otolaryngology–head & neck surgery 138(6): 584-587. Weber, P. C. (2008). Vertigo and disequilibrium: a practical guide to diagnosis and management. New York, Thieme Medical Publishers, Inc.