Vertigo is a condition in which you feel that you are spinning or tilting, or as if your surroundings are spinning around you.  It can be associated with imbalance, difficulty walking, falls, nausea or vomiting, and a decrease in one's ability to perform daily activities.  One of the most common types of vertigo is BPPV, which is caused by calcium debris abnormally stimulating of part of the vestibular system within the inner ear. 

The symptoms of BPPV are provoked by a change in the position of one's head relative to gravity.  Getting out of bed, bending, rolling in bed, looking upwards, and standing up from a seated position are all activities which may bring on the symptoms.  As opposed to other forms of vertigo, in BPPV the symptoms may not occur until up to 40 seconds following the position change, and typically last for under 60 seconds from their onset.  Repetition of the movement may lessen the symptoms, and it may be several hours before they reoccur.  Consulting with your doctor is recommended to rule out any more serious conditions, especially if the vertigo is accompanied by sudden hearing changes, weakness, difficulty speaking, facial paralysis, numbness or tingling.

Your doctor may perform caloric tests or an ENG to help in the diagnosis, and your doctor or physical therapist can perform tests in which you are taken into provoking positions.  In these tests your symptoms are monitored and the therapist will look for abnormal eye movements associated with BPPV. 

Should your symptoms be from BPPV, your therapist can perform a particle repositioning maneuver to clear the calcium crystals from the semicircular ducts of the vestibular system, removing the abnormal stimulation.  Following this procedure you will have certain precautions including not looking up or down, staying upright for 24 hours (including sleeping propped up or in a recliner), and be sure to have someone with you to drive you home.  The maneuvers are 80% effective after one treatment and 90% effective after four treatments.  Individuals who do not respond to the hands-on maneuvers or respond only partially can be given home repositioning exercises and habituation exercises.  Recurrence of BPPV is reported to be 30% after one year and 50% after five years, and can be treated by repeating the maneuvers.