BPPV
Benign paroxysmal positional vertigo — brief spinning triggered by a change of head position, such as turning over in bed or looking up. It is identified by specific positional tests during the examination.
Vertigo & Dizziness
Vertigo & Dizziness Treatment in Jammu
Dizziness may mean spinning, imbalance, light-headedness or a feeling of faintness. Identifying the exact symptom helps determine the cause.
Start here
Which Symptom Fits Yours Best?
“Dizzy” is one word for several different experiences, and they point in different directions. Select the one closest to yours to see what it usually describes — and what the examination looks at.
Spinning sensation
A false sense that you or the room is turning, often coming in episodes. This is vertigo in the strict sense, and it is the pattern most closely linked to the balance organ in the inner ear — though not exclusively.
- How long each episode lasts — seconds, minutes or hours — is one of the most useful details
- Whether it is triggered by turning over in bed or looking up
- Whether hearing has changed, or there is ringing or fullness in the ear
Imbalance
Unsteadiness on your feet without the room spinning — a sense of being pulled to one side, or of not quite trusting your footing. It is felt mainly when standing and walking rather than when lying still.
- Balance depends on the inner ear, vision and the nerves in the legs together
- Whether it is worse in the dark or on uneven ground is worth noting
- Numbness or tingling in the feet alongside it changes what is looked for
Nausea with vertigo
Feeling sick, or vomiting, alongside the spinning. The balance organ and the systems that produce nausea are closely connected, so the two often travel together — particularly when the vertigo comes on acutely.
- Severe nausea can make it hard to keep fluids down, which matters in its own right
- Headache, light sensitivity or a history of migraine alongside it is significant
- Whether it settles when you stay perfectly still helps characterise the episode
Difficulty walking
Veering to one side, needing a wall or a hand for support, or walking with the feet further apart than usual. When dizziness has reached the point of affecting walking, the examination of gait and coordination becomes central.
- Whether it came on suddenly or built up over weeks points in different directions
- Any falls, and whether there was warning before them
- Sudden difficulty walking with dizziness needs urgent assessment — see below
This is a way of describing your symptom more precisely before the consultation, not a diagnostic tool. Several conditions can produce the same sensation, and only an examination can separate them.
What is assessed
Possible Causes
Evaluation works through these in turn. Which one fits is decided by the pattern of the symptoms and the findings on examination — not by the sensation alone.
Vestibular migraine
Episodes of vertigo related to migraine, which may occur with or without headache. A personal or family history of migraine is often part of the picture.
Inner-ear causes
Problems affecting the balance organ or the nerve carrying its signals. Changes in hearing, ringing or a sense of fullness in the ear are relevant clues here.
Neurological causes
Dizziness arising from the brain or its blood supply rather than the ear. This is the group that matters most to identify quickly, which is what the urgent features below are about.
Evaluation
How Dizziness Is Evaluated
The single most useful part of the assessment is a precise account of the episodes — what brings them on, how long they last, and what comes with them.
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Step 01
The pattern
Duration, triggers, what accompanies the episodes, and how they have changed over time.
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Step 02
Examination
Eye movements, balance and gait testing, and a neurological examination to check for signs pointing beyond the inner ear.
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Step 03
Positional testing
Specific head and body position manoeuvres that can reproduce the vertigo and identify BPPV where it is present.
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Step 04
Further tests
Hearing assessment or imaging where the history and examination indicate it, rather than as a routine first step.
Treatment
Treatment Follows the Cause
Because the causes are different, the treatments are different. Using a general anti-dizziness medicine for everything is what tends to leave the problem unresolved.
Repositioning manoeuvres
A sequence of guided head and body positions used where BPPV is identified. It is performed in the clinic, takes a few minutes, and involves no medication.
Condition-specific medication
Chosen for the underlying diagnosis — for example the approach to vestibular migraine differs from that for an acute inner-ear problem.
Which treatment applies, and whether a manoeuvre is appropriate at all, is decided after examination. Positional manoeuvres should not be attempted from a video without a diagnosis — the wrong manoeuvre for the wrong problem can make matters worse.
Urgent evaluation
When Dizziness Needs Urgent Assessment
Most dizziness is not dangerous. But when it appears alongside any of the features below, it can indicate a problem in the brain or its blood supply rather than the inner ear — and that needs assessing straight away, not at the next OPD.
Go to the nearest hospital emergency department or call your local emergency number. These features overlap with stroke, where time matters.
- Dizziness with weakness
- Dizziness with double vision
- Dizziness with slurred speech
- Severe imbalance or inability to walk
Questions patients ask
Frequently Asked Questions
General information to help you prepare for a consultation — not a substitute for an assessment of your own symptoms.
What is the difference between vertigo and dizziness?
Dizziness is the broad word. Vertigo is one kind of dizziness — the false sense that you or your surroundings are spinning or moving.
Other kinds include unsteadiness on the feet, light-headedness, and a feeling of being about to faint. They arise from different mechanisms, which is why the first question in the consultation is usually what exactly you mean by dizzy.
Is vertigo always an ear problem?
No. The inner ear is the most common source, but vertigo can also come from migraine, from the nerves carrying balance signals, from certain medicines, or from the brain and its blood supply.
Separating these is the purpose of the neurological examination, and it is why the urgent features listed above are checked at every assessment.
What is a repositioning manoeuvre, and does it hurt?
It is a guided sequence of head and body positions used when BPPV is diagnosed. It is not painful and involves no injections or medication, though it can briefly bring on the spinning sensation while it is being done — that is expected.
It is not a general remedy for dizziness. It applies to a specific diagnosis, which is why it follows positional testing rather than replacing it.
Do I need an MRI for dizziness?
Usually not. Most causes of dizziness are diagnosed from the history and the examination, and a scan adds nothing when the pattern is clear.
Imaging is advised when the assessment raises the possibility of a cause inside the brain — for example when there are neurological findings, or when the dizziness came on suddenly with other symptoms.
What should I note down before the appointment?
How long a typical episode lasts, what you were doing when it started, whether turning over in bed or looking up sets it off, and whether hearing, headache or nausea come with it.
Also bring the full list of medicines you take — several common ones can cause or worsen dizziness, and that is easy to miss without the list in front of us.
Appointments
Book a consultation with a neurologist at NeuroAxis Clinic, Jammu
Come with a note of how long the episodes last and what sets them off — that detail does more to narrow the cause than any single test. Consultations run at three OPD locations across Jammu.
This website provides general information and is not a substitute for medical advice.