udden spinning when you move your head? You could have BPPV — and it's very treatable.

If you experience a sudden, intense sensation of spinning when you turn over in bed, look up, or tilt your head, you may have Benign Paroxysmal Positional Vertigo — more commonly known as BPPV. It can feel frightening and disorienting, but the good news is that BPPV is one of the most common and most successfully treated causes of vertigo. In many cases, it can be resolved in a single appointment.

What is BPPV?

BPPV occurs when tiny calcium carbonate crystals — known as otoconia or "ear crystals" — become dislodged from their usual position in the inner ear and migrate into one of the semicircular canals. These canals are filled with fluid and are responsible for detecting rotational movement. When loose crystals enter a canal, they disrupt the normal flow of fluid, sending confusing signals to the brain and triggering a sudden, brief but intense spinning sensation.

BPPV is not dangerous, and it has nothing to do with blood pressure, anxiety, or neurological disease — though it is often mistaken for all three. It can develop without any obvious cause, though it is sometimes associated with a knock to the head, prolonged bed rest, or inner ear conditions.

The episodes themselves typically last less than a minute, but the unpredictability of symptoms can make everyday activities feel difficult and exhausting.

How do we test for it?

We use the Dix-Hallpike test to diagnose BPPV. This is a simple, safe, and well-established clinical test that involves guiding you through a series of specific head and body positions while we carefully observe your eye movements.

When BPPV is present, the displaced crystals cause a characteristic pattern of involuntary eye movement called nystagmus — a rhythmic flickering that is visible to a trained clinician and tells us not only whether BPPV is present, but which ear is affected and which canal the crystals have moved into. This is important, because accurate diagnosis is essential for effective treatment.

The test takes only a few minutes and is non-invasive. You may experience a brief episode of spinning during the test, but this settles quickly and is entirely expected — it's actually a sign that we're getting the information we need.

How do we treat it?

If the Dix-Hallpike confirms BPPV, we treat it in the same appointment using the Epley Manoeuvre.

The Epley Manoeuvre is a carefully guided sequence of head and body movements designed to gently guide the displaced crystals out of the semicircular canal and back to where they belong. It works with gravity and the natural anatomy of your inner ear to reposition the crystals safely and effectively.

The procedure takes around 15 minutes, requires no medication, and is completely non-invasive. Most patients experience a significant reduction in symptoms immediately or within 24 hours. For some, a second appointment is needed to fully resolve symptoms — but the majority of people with BPPV see a clear improvement after just one session.

What to expect on the day

The appointment is relaxed and straightforward. We'll begin by taking a short case history to understand your symptoms and rule out any other contributing factors. We'll then carry out the Dix-Hallpike test, discuss our findings with you clearly, and — if BPPV is confirmed — perform the Epley Manoeuvre before you leave.

You'll go home with a clear understanding of what was found and what was done. If your symptoms don't fully resolve or return at a later date, we're here to help.

Do I need a referral?

No. You can book directly with us without a GP referral. If you recognise the symptoms described on this page, an appointment is the fastest route to getting answers and feeling better.