BPPV — benign paroxysmal positional vertigo — is the most common cause of vertigo and the most fixable: displaced inner-ear crystals send false motion signals, and repositioning maneuvers resolve most cases quickly [1]. MindForge provides instrumented BPPV diagnosis, repositioning care — and the retraining most clinics skip afterward. Free 15-minute call · (214) 730-6463.
MindForge doesn't bill insurance — by design. Direct-pay is what makes an individualized, intensive program possible rather than care shaped by billing codes. HSA/FSA and financing options exist, and a written Good Faith Estimate precedes any commitment.
What BPPV is
Tiny calcium-carbonate crystals belong in one chamber of your inner ear; when they migrate into a semicircular canal, position changes — rolling over in bed, looking up, bending down — set off brief, intense spinning. The pattern is unmistakable once tested: seconds-to-a-minute of rotational vertigo, position-triggered, often worse at night or on waking. Which canal, which side, and which variant determine which maneuver fixes it — that's why testing precedes treating.
Diagnosed by instruments, not guesswork
Positional testing with VNG-class eye-movement recording shows the characteristic nystagmus pattern and localizes the canal — turning "probably BPPV" into "left posterior canal, here's the maneuver." The battery also catches what else is riding along: vestibular migraine mimicking BPPV, hypofunction behind it, or the frequent case of BPPV plus something — which matters, because...
The part most clinics skip
Repositioning works — and a large share of patients walk out crystal-free yet still unsteady for weeks: residual dizziness after successful repositioning is common, and untreated imbalance is one reason BPPV patients keep bouncing back [1]. Our posture: fix the crystals AND measure what's left. Where posturography and gaze testing show residual impairment, a short course of Vestibular Conditioning — structured balance and gaze-stabilization retraining (the modality searchers know as vestibular rehabilitation) — finishes the job the maneuver started [2]. BPPV also recurs (roughly half of patients within years [1]); we teach you the recognition pattern and the response plan, so a recurrence costs you days, not months.
Also told in advance, because it changes nothing about success and everything about peace of mind: one to three weeks of mild dizziness after a successful maneuver is common — it shows up in roughly 20–40% of treated patients and typically reflects the crystals resettling where they belong [1]. Expected, explained, and measured if it lingers: that is the difference between a maneuver and managed care.
Evaluation and care
The MindForge Discovery Day — comprehensive neurological evaluation + report of findings + care plan — is the front door when your picture is bigger than a simple positional story (most of our patients). For clean, classic BPPV presentations, the 15-minute call will say so — sometimes the right answer is targeted repositioning care and measurement of what's left, scoped accordingly in your Good Faith Estimate; where a fuller program is indicated ("BPPV plus"), pricing is shared on that same call, with the exact quote at your wrap.
What treatment looks like: positional testing → the maneuver(s) for your canal/variant → re-test → residual-imbalance retraining only if your numbers say so → recurrence plan. (Discovery Day · what to expect)
Frequently asked questions
How fast does BPPV treatment work?
Repositioning resolves most cases in a small number of sessions [1] — and we re-test rather than assume.
Why am I still off after the Epley fixed my spinning?
Residual dizziness after successful repositioning is common and trainable [1,2] — the measured retraining is the missing step.
Will it come back?
Recurrence is real — roughly half within several years [1]; you'll leave with a recognition-and-response plan.
Can I do the Epley from YouTube?
The maneuver depends on which canal and side are involved — self-treating the wrong canal can make things worse; testing first is the safe answer.
Is treatment possible on the Discovery Day?
BPPV is the one presentation where same-day repositioning during evaluation can be clinically appropriate — your clinician decides based on findings.
Do you take insurance?
We're direct-pay, with superbills provided — see ways to pay.
Sources: [1] BPPV clinical practice guideline: Bhattacharyya N, et al. Otolaryngol Head Neck Surg. 2017;156(3_suppl):S1–S47. Repositioning vs. sham/control: Hilton MP, Pinder DK. Cochrane Database Syst Rev. 2014;(12):CD003162 — complete resolution rose from 21% to 56% (OR 4.42). Residual dizziness for 1–3 weeks after successful repositioning in 20–40% (von Brevern et al., 2006; Bremova et al., 2013); recurrence ~36% after treatment (Cochrane) and ~50% over 10 years, with 80% of recurrences in the first year (Brandt et al., 2006). [2] Vestibular rehabilitation for residual imbalance: McDonnell MN, Hillier SL. Cochrane Database Syst Rev. 2015;(1):CD005397.