Benign paroxysmal positional vertigo

Common, often self-limiting condition, but can be chronic and relapsing.

Diagnosis is based on a suggestive history and physical examination with a positive Dix-Hallpike manoeuvre or a positive supine lateral head turn. Other tests are not usually required.

Medication is not an effective treatment option.

Repositioning manoeuvres are highly efficacious in resolving an episode of BPPV.

Surgery is highly effective but is reserved for intractable and severe cases.

Benign paroxysmal positional vertigo (BPPV) is a peripheral vestibular disorder that manifests as sudden, short-lived episodes of vertigo elicited by specific head movements. BPPV is one of the most common causes of vertigo. It is often self-limiting, but can become chronic and relapsing with considerable effects on a patient's quality of life. Most cases result from the migration of free-floating endolymph canalith particles (thought to be displaced otoconia from the utricular otolithic membrane) into the posterior (more commonly), horizontal (less commonly), or anterior (rarely) semicircular canals, rendering them sensitive to gravity.[1]Parnes LS, Agrawal SK, Atlas J. Diagnosis and management of benign paroxysmal positional vertigo (BPPV). CMAJ. 2003 Sep 30;169(7):681-93. http://www.cmaj.ca/content/169/7/681.full http://www.ncbi.nlm.nih.gov/pubmed/14517129?tool=bestpractice.com