Recent advancement of BPPV management

Abstract

Benign paroxysmal positional vertigo (BPPV) is a common vestibular disorder. The recent development of diagnostic tools allowed clarification of its pathology. Dislodgement of the utricular otoconia is the basis of BPPV which leads to development of canalolithiasis or cupulolithiasis. Positional nystagmus test is a most essential bed side test. BPPV may involve multiple canals and utricle, thus showing complicated nystagmus pattern. Understanding the physiology of semicircular canals and vestibuloocular reflex allows proper diagnosis of a lesion side and types of BPPV. Based upon the basic and clinical findings, a lesion-specific physical therapy had been developed which turned out to be very effective. Nystagmus pattern can also be an index of the treatment outcome.