Benign Paroxysmal Positional Vertigo (BPPV)

Benign paroxysmal positional vertigo is a peripheral vestibular disorder caused by displacement of calcium carbonate otoconia from the utricle into one or more semicircular canals, most often the posterior canal. Lifetime prevalence reaches 2–3%.

BPPV is characterized by brief spinning vertigo attacks lasting seconds to minutes, triggered by head-position changes such as rolling over in bed, looking up, or bending forward. Nausea frequently accompanies attacks, but persistent neurological symptoms are absent.

The Dix-Hallpike maneuver diagnoses posterior canal BPPV by provoking upbeat-torsional nystagmus, while the supine roll test identifies horizontal canal involvement. Imaging is not routinely required but is warranted for atypical features.

Canalith repositioning procedures resolve symptoms in 80–90% of patients after one or two sessions, though recurrence is common and patients should receive home exercises and recurrence counseling.