Evaluation and treatment of benign paroxysmal positional vertigo

Abstract

Benign paroxysmal positional vertigo (BPPV) is characterized by brief periods of vertigo triggered by a change in the position of the patient's head relative to gravity. The diagnosis of BPPV is based on the patient's history and eye movements (nystagmus) evoked during two positional tests: the Dix-Hallpike maneuver and the supine with lateral head turnsmaneuver. The direction and characteristics of the nystagmus found during the positional testing enable the clinician to determine the canal involved. Once the involved canal is identified, BPPV may be effectively treated with a physical maneuver. The maneuvers may be performed by a clinician or by patients themselves.