Benign paroxysmal positional vertigo: Effective diagnosis and treatment

Benign paroxysmal positional vertigo (BPPV), caused by wayward crystals ("rocks") in the semicircular canals of the inner ear, is the most common cause of brief symp-toms of vertigo secondary to head and body movements. Diagnosing and treating it are simple to do in the medical office. This article reviews the differential diagnosis for patients presenting with dizziness and vertigo, the patho-physiology of BPPV, how to diagnose it using maneuvers to elicit symptoms and nystagmus, how to interpret the nystagmus pattern to determine where the rocks are, and how to treat it using different maneuvers to reposition ("roll") the rocks back where they belong.