BPPV is treated with canalith repositioning, a sequence of head and body positions that moves displaced particles out of the affected semicircular canal. The Epley manoeuvre is the most widely used version, and many people improve after one or two treatments.
BPPV is treated with canalith repositioning, a sequence of head and body positions that moves displaced particles out of the affected semicircular canal. The Epley manoeuvre is the most widely used version, and many people improve after one or two treatments.
BPPV happens when small calcium carbonate crystals, normally sitting elsewhere in the inner ear, become displaced into one of the semicircular canals. Head movement then makes them shift, sending a false signal of rotation. Repositioning uses gravity: a specific sequence of head and body positions guides the particles out of the canal and back where they cause no trouble. It treats the mechanism rather than masking the symptom.
It is performed in the office and takes a series of positions held for a short time each. It will provoke vertigo during the procedure, which is expected and indicates it is reaching the right structures. Many people notice a substantial improvement immediately, though some feel unsteady for a day or two afterwards. If the first attempt does not fully resolve it, repeating it is normal rather than a sign of failure.
Vestibular suppressant medications such as antihistamines and anti-nausea drugs reduce the sensation but do not move the particles, so they do not treat the cause. Used beyond the short term they can actually delay recovery by interfering with the brain's natural compensation. They also suppress the responses measured by balance testing, which is why you may be asked to stop them before a VNG study.
Clinical Neurology Specialists has been physician-owned since 1998, when Leo Germin, M.D., FAANEM founded it. Five board-certified neurologists and four advanced practice providers see patients at the Las Vegas and Henderson offices, each with its own AANEM-accredited electrodiagnostic laboratory.
Clinical Neurology Specialists is an adult outpatient neurology practice for patients 18 and older. The practice performs no surgery and operates no imaging suite, infusion suite or interventional pain programme, and provides no emergency or inpatient care.
Physician-reviewed. Reviewed by the physicians of Clinical Neurology Specialists — board-certified neurologists, AANEM-accredited electrodiagnostic laboratories, physician-owned since 1998. Reviewed 1 August 2026. This article is general education for adults 18 and older and is not a substitute for a consultation.
Sources and further reading: MedlinePlus: dizziness and vertigo; MedlinePlus, National Library of Medicine; American Academy of Neurology.
Adults 18 and older, at the Las Vegas and Henderson offices. Call 702-804-1212 or request an appointment online.