Diagnosis and management of benign paroxysmal positional vertigo

Benign Paroxysmal Positional Vertigo (BPPV) is the most common peripheral vestibular disorder, especially among older adults. It is characterized by sudden, transient episodes of vertigo triggered by specific changes in head position. The underlying mechanism involves dislodged otoconia entering one of the semicircular canals, causing abnormal stimulation of the vestibular system. This review provides a comprehensive overview of the vestibular anatomy, pathophysiology of BPPV, diagnostic methods including the Dix-Hallpike and Supine Roll Tests, differential diagnoses, and current therapeutic approaches. Effective diagnosis relies heavily on clinical history and positional testing, while treatment primarily involves canalith repositioning maneuvers. Surgical options are reserved for persistent, treatment-resistant cases. This manuscript aims to provide a complete clinical guide to the diagnosis and management of BPPV.