Skip to main content
SpringerLink
Log in

Paroxysmal positional vertigo

  • Review
  • Published:
The Italian Journal of Neurological Sciences Aims and scope Submit manuscript

Abstract

Paroxysmal positional vertigo (PPV) is the peripheral vertiginous syndrome that is most frequently encountered in clinical practice. It is characterised by paroxysmal vertiginous attacks that are triggered by head movements and last no more than a few seconds, and is often accompanied by nausea and vomiting. The aim of this review is to provide a complete and updated description of the two principal manifestations of the syndrome: posterior semicircular canal (PSC-PPV) and horizontal semicircular canal PPV (HSC-PPV).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Adler D (1897) Uber den ‘einseitigen Drehscwidel’. Dtsch Z Nervenheilkd 11:358–375

    Google Scholar 

  2. Barany R (1921) Diagnose von Krankheitserscheinungen im Bereiche des Otolithenapparates. Acta Otolaryngol 2:434–437

    Google Scholar 

  3. Borries G (1925) Statisch (Zephalostatisch) ausgeloster Nystagmus. Arch Ohren Nasen Kehlkopfheilkd 112:53–63

    Google Scholar 

  4. Dix MR, Hallpike CS (1952) Pathology, symptomatology and diagnosis of certain common disorders of the vestibular system. Ann Otol Rhinol Laryngol 61:987–1016

    Google Scholar 

  5. Baloh R, Honrubia V, Jacobson K (1987) Benign positional vertigo: Clinical and oculographic features in 240 cases. Neurology 37:371–37

    Google Scholar 

  6. Katsarkas A, Kirkham TH (1978) Paroxysmal positional vertigo: A study of 255 cases. J Otolaryngol 7:320–330

    Google Scholar 

  7. Stahle J, Terrins J (1965) Paroxysmal positional nystagmus. Ann Otol Rhinol Laryngol 74:69–8324

    Google Scholar 

  8. Schuknecht HF (1969) Cupulolithiasis. Arch Otolaryngol 90:765–778

    Google Scholar 

  9. Hall SF, Ruby RRF, McClure JA (1979) The mechanism of benign paroxysmal vertigo. J Otolaryngol 8:151–158

    Google Scholar 

  10. Epley JM (1980) New dimensions of benign paroxysmal vertigo. Otolaryngol Head Neck Surg 88:599–605

    Google Scholar 

  11. Brandt T, Steddin S (1993) Current view of the mechanism of benign paroxysmal positioning vertigo: Cupulolithiasis or canalolithiasis? J Vestib Res 3:373–382

    Google Scholar 

  12. Lanska DJ, Remler B (1997) Benign paroxysmal positioning vertigo: Classic descriptions, origins of the provocative positioning technique, and conceptual developments. Neurology 48:1167–1177

    Google Scholar 

  13. Fung K, Hall F (1996) Particles repositioning maneuvre: Effective treatment for benign paroxysmal positional vertigo. J Otolaryngol 25:243–248

    Google Scholar 

  14. Sheikholeslam-Zadeh R (1996) Cupulolithiasis and canalolithiasis are two photos of a story called lsthe destiny of the otoconia’. Arch Otolaryngol Head Neck Surg 122:206–207

    Google Scholar 

  15. Nuti D, Pagnini P (1992) Epidemiologia della Cupulolitasi. In: Atti XII Giornata Italiana di Nistagmografia Clinica. Viterbo 11 aprile 1992, Boots-Formenti, Milano, pp 25–34

    Google Scholar 

  16. Bloom JE, Katsarkas A (1989) Paroxysmal positional vertigo in the elderly. J Otolaryngol 18:96–98

    Google Scholar 

  17. Lindsay JR, Hemenway WG (1956) Postural vertigo due to unilateral sudden partial loss of vestibular function. Ann Otol Rhinol Laryngol 65:692–708

    Google Scholar 

  18. Harrison MS (1956) Notes on the clinical features and pathology of post-concussional vertigo, with special references to positional nystagmus. Brain 79:474–482

    Google Scholar 

  19. Sandstrom J (1962) Cervical syndrome with vestibular symptoms. Acta Otolaryngol (Stockh) 54:207–226

    Google Scholar 

  20. Janeta PJ (1975) Neurovascular cross-compression in patients with hyperactive dysfunction symptoms of the eighth cranial nerve. Surg Forum 26:467–469

    Google Scholar 

  21. Spector M (1961) Positional vertigo after stapedectomy. Ann Otol Rhinol Laryngol 70:251–254

    Google Scholar 

  22. McClure JA, Rounthwaite J (1977) Vestibular dysfunction associated with benign paroxysmal vertigo. Laryngoscope 87:1434–1442

    Google Scholar 

  23. Citron L, Hallpike CS (1956) Observations upon the mechanism of positional nystagmus of so-called benign paroxysmal type. J Laryngol Otol 70:253–295

    Google Scholar 

  24. Citron L, Hallpike CS (1962) A case of positional nystagmus of the so-called benign paroxysmal type and the effects of treatment by intracranial division of the VIIIth nerve. J Laryngol Otol 76:28–33

    Google Scholar 

  25. Gacek RR (1991) Singular neurectomy update. II. Review of 102 cases. Laryngoscope 101:855–862

    Google Scholar 

  26. Gacek RR (1974) Transection of the posterior ampullary nerve for relief of benign paroxysmal positional nystagmus. Ann Otol Rhinol Laryngol 83:596–605

    Google Scholar 

  27. Parnes LS, McClure JA (1990) Posterior semicircular canal occlusion for intractable benign paroxysmal positional vertigo. Ann Otol Rhinol Laryngol 99:330–334

    Google Scholar 

  28. Cohen B, Suzuki JI, Bender MB (1964) Eye movement from semicircular canal nerve stimulation in the cat. Ann Otol Rhinol Laryngol 73:153–169

    Google Scholar 

  29. Parnes LS, McClure JA (1992) Free-floating endolymph particles: A new operative finding during posterior semicircular canal occlusion. Laryngoscope 102:988–992

    Google Scholar 

  30. Kveton JF, Kashgarian M (1994) Particulate matter within the membranous labyrinth: Pathologic or normal? Am J Otol 15:173–176

    Google Scholar 

  31. Welling DB, Pames LS, O'Brienn B et al (1997) Particulate matter in the posterior semicircular canal. Laryngoscope 107:90–94

    Google Scholar 

  32. Moriarty B, Rutka J, Hawke M (1992) The incidence and distribution of cupular deposits in the labyrinth. Laryngoscope 102:56–59

    Google Scholar 

  33. Brandt T, Steddin S (1992) Reply to the letter by Gordon: “Benign paroxysmal positional vertigo (BPPV) or bubble provoked positional vertigo?”. J Neurol Sci 111:231–233

    Google Scholar 

  34. Gordon AG (1992) BPPV-benign paroxysmal positional or bubble provoked positioning vertigo? J Neurol Sci 111:229–230

    Google Scholar 

  35. Vicini C, Cunsolo E (1992) Clinica della Cupuolitiasi del canale semicircolare posteriore. In: Atti XII Giornata Italiana di Nistagmografia Clinica. Viterbo, 11 aprile 1992. BootsFormenti, Milano, pp 53–80

    Google Scholar 

  36. Steddin S, Brandt T (1994) Unilateral mimicking bilateral benign paroxysmal positioning vertigo. Arch Otolaryngol Head Neck Surg 120:1339–1341

    Google Scholar 

  37. Baloh RW, Jacobson K, Honrubia V (1993) Horizontal semicircular canal variant of benign positional vertigo. Neurology 43:2542–2549

    Google Scholar 

  38. Cipparrone L, Corridi G, Pagnini P (1985) Cupulolitiasi. In: Atti V Giornata Italiana di Nistagmografia Clinica. San Marino, 13 aprile 1985. Boots-Formenti, Milano, pp 36–53

    Google Scholar 

  39. De La Meilleure G, Dehaene I, Depondt M et al (1996) Benign paroxysmal positional vertigo of the horizontal canal. J Neurol Neurosurg Psychiatry 60:68–71

    Google Scholar 

  40. McClure A (1985) Horizontal canal BPV. Am J Otolaryngol 14:30–35

    Google Scholar 

  41. Nuti D, Vannucchi P, Pagnini P (1996) Benign paroxysmal vertigo of the horizontal canal: A form of canalolithiasis with variable clinical features. J Vestib Res 6:173–184

    Google Scholar 

  42. Pagnini P, Nuti D, Vannucchi P (1989) Benign paroxysmal vertigo of the horizontal canal. ORL J Otorhinolaryngol Rel Spec 51:161–170

    Google Scholar 

  43. Baloh RW, Yue Q, Jacobson KM et al (1995) Persistent direction-changing positional nystagmus: Another variant of benign positional nystagmus? Neurology 45:1297–1301

    Google Scholar 

  44. Steddin S, Brandt T (1996) Horizontal canal benign paroxysmal positioning vertigo (h-BPPV): Transition of canalolithiasis to cupulolithiasis. Ann Neurol 40:918–920

    Google Scholar 

  45. Brandt T, Daroff RB (1980) Physical therapy for benign paroxysmal positional vertigo. Arch Otolaryngol 106:484–489

    Google Scholar 

  46. Semont A, Freyss G, Vitte E (1988) Curing the BPPV with a liberatory maneuver. Adv Otolaryngol 42:290–293

    Google Scholar 

  47. Coppo GF, Singarelli S, Fracchia P (1996) La vertigine parossisica posizionale benigna: Follow-up di 165 pazienti trattati con manovra liberatoria di Semont. Acta Otorhinolaryngol Ital 16:508–512

    Google Scholar 

  48. Guidetti G, Manzoni D, Galletti G (1988) II contributo della manovra di Semont alla diagnosi e alla risoluzione delle vertigini parossistiche da posizionamento. Rivista critica di 310 casi. Acta Otorhinolaryngol Ital 8:493–497

    Google Scholar 

  49. Herdman SJ, Tusa RJ, Zee DS et al (1993) Single treatment approaches to benign paroxysmal position vertigo. Arch Otolaryngol Head Neck Surg 119:450–454

    Google Scholar 

  50. Ireland DJ (1992) The Semont maneuver. In: Krecjova H, Jerabek J (eds) Proc XVIIth Barany Society Meeting. Castle Dobris, Czechoslovakia, June 2–5 1992, pp 367–380

  51. Epley JM (1992) The canalith repositioning procedure for treatment of benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg 107:399–404

    Google Scholar 

  52. Ciniglio Appiani G, Gagliardi M, Urbani L et al (1996) The Epley maneuver for the treatment of benign paroxysmal positional vertigo. Eur Arch Otorhinolaryngol 253:31–34

    Google Scholar 

  53. Herdman SJ, Tusa RJ (1996) Complications of the canalith repositioning procedure. Arch Otolaryngol Head Neck Surg 122:281–286

    Google Scholar 

  54. Lynn S, Pool A, Rose D et al (1995) Randomized trial of the canalith repositioning procedure. Otolaryngol Head Neck Surg 113:712–720

    Google Scholar 

  55. Steenerson RL, Cronin GW (1996) Comparison of the canalith repositioning procedure and vestibular habituation training in forty patients with benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg 114:61–64

    Google Scholar 

  56. Parnes LS, Price-Jones RG (1993) Particle repositioning maneuver for benign paroxysmal positional vertigo. Ann Otol Rhinol Laryngol 102:325–331

    Google Scholar 

  57. Welling DB, Barnes DE (1994) Particle repositioning maneuver for benign paroxysmal positioning vertigo. Laryngoscope 104:946–949

    Google Scholar 

  58. Katsarkas A (1995) Paroxysmal positional vertigo: An overview and the deposits repositioning maneuver. Am J Otol 16:725–730

    Google Scholar 

  59. Harvey SA, Hain TC, Adamiec LC (1994) Modified liberatory maneuver: Effective treatment for benign paroxysmal positional vertigo. Laryngoscope 104:1206–1212

    Google Scholar 

  60. Lempert T, Tiel-Wilck K (1996) A positional maneuver for treatment of horizontal canal benign positional vertigo. Laryngoscope 106:476–478

    Google Scholar 

  61. Vannucchi P, Giannoni B, Pagnini P (1997) Treatment of horizontal semicircular canal benign paroxysmal positional vertigo. J Vestib Res 7:1–6

    Google Scholar 

  62. Zucca G, Mira E, Valli S et al (1998) Why do BPPV episodes recover spontaneously? J Vestib Res

  63. Gacek RR (1985) Pathophysiology and management of cupulolithiasis. Am J Otolarhyngol 6:66–74

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Otorhinolaryngology, University of Pavia IRCCS Policlinico San Matteo, P.le Golgi 2, I-27100, Pavia, Italy

    E. Mira & S. Mauri

Authors
  1. E. Mira
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. Mauri
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mira, E., Mauri, S. Paroxysmal positional vertigo. Ital J Neuro Sci 19, 150–160 (1998). https://doi.org/10.1007/BF00831565

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00831565

Key words

Search

Navigation