Benign paroxysmal positional vertigo
Brief, position-triggered vertigo caused by displaced otoconia in a semicircular canal; diagnose with positional testing and treat posterior-canal disease with a canalith-repositioning manoeuvre.
Definition
Benign paroxysmal positional vertigo is a peripheral vestibular disorder caused by displaced otoconia entering a semicircular canal, producing brief episodes of vertigo triggered by head position.
First principles
BPPV is a mechanical problem in the inner ear
Otoconia that normally sit in the utricle can enter a semicircular canal. Head movement then makes the particles move under gravity, producing an abnormal vestibular signal and a short burst of vertigo. The posterior canal is most often involved, but horizontal and anterior canal variants need different positional findings and manoeuvres.
This page is exam revision material, not medical advice, and must not be used for patient care. Always check drug doses against the BNF and current guidance. Full disclaimer.

