One form of dizziness is vertigo. This is usually associated with our inner ear or vestibular system and is called Benign Paroxysmal Positional Vertigo or BPPV. BPPV is an inner ear problem related to loos crystals (Otolith) that are not where they should be. Our inner ear has a very sensitive system to tell us when our head is moving and controls our balance. When there is a problem with this system, we experience vertigo and nausea. If this is you, these crystals may be loose and lodged in the tubes (semi-circular canals) of the inner ear. You have three canals in each ear, a posterior canal, an anterior and a horizontal.

The best form of diagnostic testing for BPPV is through video oculography or goggle testing. An infrared or night vision camera is used to record eye movement and display this on a monitor. Ask if your practitioner uses this advanced form of testing to get the best results and best chance of recovery.

Treatment of BPPV is through different techniques, most commonly the Epley Maneuver. This is used to try to ‘roll’ the crystal out of the semi-circular canal and is very effective. The Epley Maneuver only works for a posterior canal problem. If there is a crystal lodged in the other canals (anterior and horizontal), other techniques need to be used for successful treatment.


  • Get the right diagnosis. It doesn’t matter what you treat if you do not know what you have.
  • Video oculography is necessary to treat BPPV. It determines what canal is involved and what specific treatment is needed.
  • Your neck may be the underlying cause.
  • Exercises help temporarily but do not last. Treat the cause, not the symptoms.