Doctor points to inner-ear condition as common cause of sudden dizzy spells and outlines treatment and related health advice

Benign paroxysmal positional vertigo (BPPV), an inner‑ear disorder, is a frequent cause of sudden spinning sensations triggered by head movement and can usually be treated outside hospital, Dr. Martin Scurr said in a health column published Sept. 15, 2025.

Scurr, a general practitioner and medical columnist, described a classic presentation of BPPV after a reader reported a severe episode of vertigo when getting out of bed followed by ongoing dizziness with sudden movement. He said the condition occurs when tiny calcium crystals in the inner ear become dislodged and stimulate balance hair cells, disrupting signals sent to the brain and producing a spinning sensation often accompanied by nausea. The dizzy spells are typically brief, lasting about a minute, although nausea or unsteadiness between attacks can persist.

Scurr advised that BPPV is commonly provoked by actions such as getting out of bed, rolling over, looking up or down, or bending over. He said causes are not always clear but may include inner‑ear inflammation such as labyrinthitis, trauma from a fall or sports injury, and possibly a deficiency in vitamin D because the dislodged crystals are calcium‑based and vitamin D affects calcium metabolism.

Treatment for BPPV is usually noninvasive. Scurr recommended the Epley manoeuvre, a sequence of guided head and body movements intended to reposition the crystals within the inner ear. He said most general practitioners and physiotherapists can teach patients how to perform the manoeuvre and that it is normally effective. Short‑term medications that suppress motion‑sickness symptoms may be used in acute episodes, and people with recurrent BPPV should be tested for vitamin D deficiency because some research suggests supplements can reduce recurrence.

Although BPPV is classed as benign, Scurr warned it can substantially affect quality of life and increase the risk of falls and injury. He urged patients experiencing positional vertigo to see a general practitioner and consider referral to a neurotologist, a specialist in inner‑ear and balance disorders, for assessment and management.

Scurr addressed other reader concerns in the same column, including erectile difficulties in older men. Writing in response to an 82‑year‑old reader, he called age the strongest risk factor for erectile disorder, noting that vascular changes, lower testosterone levels and reduced nerve function make erectile dysfunction common in later life. He cited studies indicating about 65% of men aged 70 to 80 have some degree of erectile dysfunction, rising to roughly 75% in men over 80, leaving only about 25% of men above 80 with normal erectile function.

On medications, Scurr said the reader’s blood pressure medicine, statin and blood thinner were unlikely to be the primary cause and noted evidence that statins can slightly improve erectile function. He suggested discussing tadalafil with a general practitioner; tadalafil works like sildenafil but can enable erections for up to 36 hours in some men and is not known to interact with the reader’s listed medicines. Scurr also recommended testing for elevated blood sugar, because even mild diabetes can damage nerves important for erection, and checking testosterone levels since low testosterone can contribute to erectile problems. He cautioned that testosterone therapy only helps when levels are abnormally low.

In a separate section reflecting on seasonal respiratory threats, Scurr described respiratory syncytial virus (RSV) as a recurring autumn concern from his decades of on‑call practice. He recalled severe cases of croup in children caused by RSV and noted that the virus is also a serious risk for older adults, potentially leading to respiratory infection and pneumonia. Scurr highlighted a newly available vaccine for older adults, saying trials showed about an 82% reduction in hospital admissions for those over 75. He encouraged eligible seniors to discuss the RSV vaccine with their practice when receiving their annual influenza shot.

Medical practitioners and public health officials routinely recommend that patients with new, unexplained dizziness seek assessment to rule out other causes such as stroke, cardiac events, medication side effects or neurological disorders. Scurr’s column emphasized common, treatable explanations and urged primary care assessment, targeted repositioning therapy for BPPV, vitamin D evaluation for recurrent cases, and appropriate specialist referral when symptoms persist or complications arise.

The column combined individual clinical advice with broader prevention messages: older adults should be alert to balance problems because of fall risk, men experiencing erectile difficulties should have cardiovascular and metabolic screening as part of evaluation, and seniors should consider RSV vaccination as part of autumn respiratory protection. All specific treatment options and diagnostic tests mentioned by Scurr should be discussed with a treating clinician to confirm suitability and safety for individual patients.