BENIGN  POSITIONAL  VERTIGO
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Benign Positional Vertigo is the most common form of vertigo - its incidence increasing with age.

Episodes are typically of very sudden onset and patients may wake with them. The dizziness is normally a sensation of uncontrolled rolling (towards the side of the affected ear), with balance disturbance and associated nausea or vomiting. Once triggered, the vertigo may persist for days or even months - the symptoms are aggravated by head movement. The severity can vary from mild to severe.

In individuals certain head movements will aggravate the symptoms - these may be rolling over in bed, tilting the head backwards, moving from lying to sitting or lying on one side.

Benign Positional Vertigo is caused by crystals forming in the fluid filled chamber of the inner ear - if these crystals lodge in the sensitive 'semi-circular canals', which are part of the inner ear, they interfere with the nerve endings which sense movement and control balance - acute onset of vertigo being the result.

Treatment
During an acute episode, keep the head as still as possible and avoid the particular head movements which trigger the symptoms.
Medications such as Stemetil or Serc will help control symptoms.
Be careful driving.
Exercises have been developed which may be of benefit and are designed to dislodge the crystals from the semi-circular canals - the Brandt-Daroff exercises are described below.

Brandt-Daroff Exercise

Method
Sit on the edge of a bed.
Turn the head about 45 degrees to the left side and then quickly lie down onto your right side, ensuring the back of the head comes to rest on the bed. Remain in that position for 20 to 30 seconds until any dizziness has settled.
Sit up straight and wait for a further 20 to 30 seconds until any dizziness has settled.
Repeat on the other side (turning head to right and lying on left side etc).
The exercises should be performed around 5 times to each side and repeated 3 times a day - each session taking around 10  minutes.

The exercise is thought to be beneficial only if it reproduces dizziness.

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