After a thorough history and physical, many tests may need to be done to differentiate the various types of vertigo. These tests range from blood tests to tests of inner ear function. When BPPV occurs, there is an involuntary movement of the eyes called nystagmus which occurs. This is not recommended now since the patient must unnecessarily endure vertigo that could otherwise be easily treated. Certain balance exercises may be helpful.
Improvement occurs slowly over six month or more.
The exercises themselves may create much vertigo and nausea. This is a non-surgical office procedure in which the offending crystals are repositioned to an area in the inner ear where they won't stimulate the balance nerve. This is usually considered if the person is severely incapacitated, and all other methods have been exhausted. Depending on the hearing function, the balance organ can be either saved or destroyed or the nerve in the involved ear can be cut. It is nonsurgical, painless and has few if any side effects.