Benign – it is not life-threatening
Paroxysmal – it comes in sudden, brief spells
Positional – it gets triggered by certain head positions or movements
Vertigo – a false sense of rotational movement

BPPV is the most common condition affecting the vestibular system. It can occur spontaneously in people of all ages.

Signs and Symptoms include:

- Brief episodes of vertigo following certain head movements
- Nystagmus (involuntary eye movement)
- Nausea
- Imbalance
- Increased risk of falls


The cause of BPPV is unknown. It can occur following a knock to the head, degeneration of the vestibular system as we age, or because of damage caused by another inner ear disorder.

It is thought that otoconia, (miniscule particles or crystals) from the utricle are dislodged into one of the semicircular canals. The brain then receives information about head movement that conflicts with the signals it receives form the vestibular apparatus in the non-affected ear, the eyes and the proprioceptors in the neck. This conflicting sensory input received by the brain results in the symptoms of vertigo, nystagmus (involuntary eye movements), nausea and imbalance.


We use Frenzel goggles or infrared video goggles to examine the direction and duration of nystagmus provoked by different head positions. This then determines in which semicircular canal the otoconia is located and whether it is free floating, (canalithiasis) or adhered to structure in the semicircular canal called the cupula (cupulolithisis).


At Best Balance Physiotherapy we can effectively treat BPPV with a series of positional manoeuvres. Once it is established where the otoconia is located in the semicircular canals, a positional manoeuvre is selected to move the otoconia out of the affected canal and back into the utricle.

  • 15 Years Experience

    Melinda has over 15 years' experience as a Physiotherapist, she is a titled Musculoskeletal Physiotherapist and a specialist in Vestibular Rehabilitation.

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  • Feeling Dizzy?

    If you have symptoms of Dizzyness, Vertigo or Balance issues. Contact us today for an appointment.

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  • Opening Hours

    • Saturdays at Karrinyup Physiotherapy Centre
    • Please contact us for evening appointments.