How long does BPPV last? Why does it go and come back?

We were recently asked, “Why does BPPV go away and come back?”.  To understand the treatment and natural history of BPPV it helps to understand how it happens in the first place.  
Lets imagine that the inner ear is akin to a tiny snow globe inside the head.  In a healthy person the snow inside this globe is actually stuck down but with age the snow comes loose and begins to fly around when disturbed.  Now lets imagine there is a house inside the snow globe.  Inside the house are the very sensitive balance organs of the inner ear.  There are, of course, windows in the house and sometimes flying snow comes in through those windows.  When that happens you get BPPV. 
Every time the snow globe is disturbed, by rolling over or looking up, the snow inside the house causes the balance organs to be confused and the sensation of vertigo results.   The snow can fall out of the windows of the house as well but this only happens sometimes when you are in just the right position.   The treatment maneuver for BPPV carefully guides these particles out.  You can have your doctor do the maneuver or do it yourself with a BPPV treatment device.
Without treatment BPPV often lasts 2 weeks until the particles inside the house (which is actually called the posterior semi-circular canal) fall out or somehow breakup.  However, more snow can come in and usually does in about 60% of people. 

16 Responses

  1. Clearwater Clinical
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    Sadly the feeling you get after an episode of BPPV just has to wear off. I find that the faster you treat BPPV (the fewer episodes you have during any one period) the shorter the duration of recovery. So I mean that if you get up in bed and have BPPV then do the Epley maneuver right then, then go back to bed for a few hours. Wake up again and usually I find that things are much better. However, taking meds and staying in bed is not a good compensatory strategy once you have recovered from the initial episode. Moving around and moving your head, will help you brain get back to normal. Good luck.

  2. Suzy
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    I had my 1st episode of ‘bv’ about 5 yrs ago. I had just gone to bed when suddenly my head felt like it was spinning, then dizziness & nausea joined in. I went into a cold sweat, vomiting, the dizziness lasted for 7 hrs. I ended up lying on the floor fearing I was going to fall off the bed. I clutched my fingers into the floor because it felt like I was going to spin off & fly away. This episode took a few days to settle. The other day it happened again while I was out in my front garden. I felt a dizzy spell come on & felt light headed. I had to sit & lean against the wall for support. I couldn’t stand up or walk & the only way I could get back inside was to crawl back & drag myself in. After vomiting & rest it seems to have settled. It’s been 3 days now & the dizziness has stopped but I still feel unsettled, what can I do to control this?

  3. Clearwater Clinical
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    Thanks for the comment.

    The risk of ‘moving from 1 chamber to another’ is low, and even in the even of this happening it is usually brief (although intense).

    Most people prefer to have the Epley and get rid of BPPV (for years if not completely), rather than live with it. If you do nothing it will persist for weeks to months to years. If you do the Epley it will mostly likely go away quickly. You can do it at home if you like with DizzyFIX of with your ENT physician or vestibular physiotherapist.

    In most cases you should not have to “live with it”

    Make sure to discuss any plans with your own physician.

    Good luck.

  4. Alex Smith
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    Had this for around year. Went away by about 75%. But always in the background. Had the manoeuvre done. But risk moving from one camber to the other. You just live with it now.

  5. Clearwater Clinical
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    Thanks for the comments. BPPV is easy to treat in most cases. I would seek someone who has experience like an ENT or a neurologist who specializes in vertigo. If you have BPPV then discuss an Epley maneuver or home treatment with DizzyFIX with your physician.

  6. Mishka
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    I was just diagnosed with bppv, I had a very scary attack last Saturday late at night, dizzy and nauseated. Finally after 3 er visits and someone to listen got told what it was, now just hopping it goes away soon,

  7. sandy
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    Hello fellow dizzies , I have been dealing with this for 3 years! I am constantly looking for answers , I have bppv but also am dizzy 24 hours a day , then go into attacks , anyone else have this ? I have seen many drs no answers other than possible meniers or possible MAV and also BPPV

  8. Clearwater Clinical
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    Quick answer – yes and no.

    Long answer – No BPPV and tinnitus are not causally related. However, BPPV can often ride along with other forms of vertigo like meniere’s disease, which is associated with tinnitus and hearing loss. So yes you can have tinnitus and BPPV and they often occur together but they are not related from a disease standpoint.

    Thanks

  9. judi
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    Is tinnitus connected to BPPV?

  10. judi
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    I have been diagnosed with BPPV but also suffer from tinnitus. Are the two connected?

  11. Clearwater Clinical
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    Dizziness looking down is not BPPV. However, BPPV can be very recurrent. If you have recurrent BPPV in the posterior canal then the DizzyFIX might be a nice way to treat it at home. Usually horizontal (lateral) canal BPPV is short lived but quite intense.

  12. JS
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    Hello,

    I’ve been treated for BPPV twice in the past two months using the barbecue roll (or something to that effect), but the keeps returning. How often does this recur typically? Is there anything else I should/could be doing? Also, the ENT said my rocks (my word. Forgot what they called it) were in one area–apparently a less than typical area–lateral canal, maybe? Is it possible to have issues in other canals and that maybe that is why I continue to have issues? And if so, how would I deal with these? Also, I had nystagmus on the down gaze and notice I tend to feel dizzy when I look down (head in same position but eyes shifted downward, like when reading). Is there a way to solve this?

    Thanks!

  13. Clearwater Clinical
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    Thanks for your comments. Can you clarify what you mean by “dizzy”, do you mean spinning dizziness or just off balance? It is common to have an “off balance” feeling after a correct BPPV treatment maneuver which lasts weeks. However, if you still get dizzy with turning when laying down then you may not have complete resolution and could benefit from a second manevuer. You may also have a different diagnosis. It may be worth clarifying with you own doctor. Depending on what you do for you work don’t put yourself at risk if you feel dizzy (ie no ladders etc)

  14. devona
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    Bart, thanks for the info. Did u go to work w/these symptoms? I’ve been going though this for 2 wks & 3 days I feel better at times when I’m just sitting Watchn tv then I get up & there if goes my doctor did the movements it help a little bit but I’m still dizzy. Help…

  15. admin
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    That’s a very interesting situation and not all that uncommon. The answer is yes it is possible to have both. Unfortunately BPPV is a side effect of any injury to the ear. That injury may be as simple as ongoing age, but also can be due to head trauma, infections or other ear diseases like Meniere’s. Vertigo and dizziness that lasts longer than a minute or so is not BPPV. Other possibilities include a “Fistula” which causes hearing loss and vertigo intermittently. There are treatments for all of these which in some cases include surgery or injections of medication into the ear. Vertigo can be a difficult problem so it is important to seek local diagnosis and treatment. If your local ENT can’t help then find a “neurotologist” – who is a specialized ENT dealing with the inner ear. Regards.

  16. Bart Wiley
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    Can bppv last for a year, I’m tryn to figure out if I have meniers it bppv it seems like I have some symptoms of both , I feel pressure in my head, but on other hand my eyes twitch or bounce when ever I put my head in a onward position it’s weird I have attacks that come about every 5 days I’ll be dizzy for about 3 days straight both some realy bad attacks in those three days then it will leave an come right back again , it’s been doing this for about a year now , if u have any suggestion about my diagnosis I would be greatfull my ENT can’t seem to help me out

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