Benign Paroxysmal Positioning Vertigo (BPPV)

Benign paroxysmal positional vertigo (preferably described as positioning vertigo) was initially described by Bárány in 1921, and the term was coined by Dix and Hallpike (1952). In this condition brief attacks of rotational vertigo and concomitant positioning rotary-linear nystagmus are precipitated by rapid head extension and by lateral head tilt towards the affected ear (Fig. 11.1). Cupulolithiasis of the posterior semicircular canal is responsible (Schuknecht 1969), and the condition is the most common cause of vertigo in the elderly. Spontaneous recovery is common, but there is also a high effective form of mechanical therapy which involves the use of positioning manoeuvres applied serially (Brandt and Daroff 1980).