Ear/Dizzy Topics
Diagnosing and Treating BPPV
by Dr. Christopher Chang, last modified on
4/13/21.
DISCLAIMER : We do NOT consider ourselves "dizzy" experts, but provide the following info as a service to patients. Incorrect self-diagnosis is a risk that may lead to injury and further balance problems. Use of the following information is only meant as an educational tool. Please see your doctor to be formally diagnosed and treated.
BPPV is one of the most common causes of imbalance in any age group affecting nearly 20% of all dizzy patients. The following guide is to help determine whether BPPV is the cause of your dizziness as well as provide the proper treatment to correct this disorder.
Please keep in mind that this flowchart is a general guide and that there are subtleties that are not addressed here.
As a FIRST step, perform the Dix-Halpike Maneuver
Please watch the ENTIRE video below first prior to performing. Please note that if you have a positive response, you must repeat the maneuver 2 more times to note for any fatigue. Positive response is seeing nystagmus (eye twitching)... Feeling dizzy by itself is NOT considered a positive response. Fatigue is when the nystagmus weakens when repeating the same maneuver. After performing, answer the questions below.
| If no nystagmus was seen, than you do not have BPPV regardless of whether you felt dizzy or not. | Click here if this sounds like you. |
| Was nystagmus present, but did not fatigue with repetition? | Click here if this sounds like you. |
| If fatiguable nystagmus was present, was it torsional? | Click here if this sounds like you. |
| If fatiguable nystagmus was present, was it side-to-side? | Click here if this sounds like you. |
| If fatiguable nystagmus was present, was it vertically oriented? | Click here if this sounds like you. |
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