Benign paroxysmal positional vertigoBMJ 2003; 326 doi: https://doi.org/10.1136/bmj.326.7391.673 (Published 29 March 2003) Cite this as: BMJ 2003;326:673
A safe and effective treatment is available for this well defined condition
- Malcolm Hilton (email@example.com), consultant otolaryngologist,
- Darren Pinder, specialist registrar in otolaryngology (firstname.lastname@example.org)
- Royal Devon and Exeter Hospital, Exeter EX2 5DW
Benign paroxysmal positional vertigo is one of the few disorders of balance for which there is a simple, safe, and highly effective treatment. Although vertigo is rarely a presenting complaint of serious underlying pathology, it is a symptom that is both distressing and highly disruptive.
Benign paroxysmal positional vertigo is characterised by shortlived episodes of vertigo in association with rapid changes in head position. The pathology usually lies in the posterior semicircular canal of the inner ear. It is now widely accepted that “canalolithiasis” causes this condition. Free floating debris in the endolymph of the semicircular canal is assumed to act like a plunger, causing continuing stimulation of the auditory canal for several seconds after movement of the head has ceased. The condition is idiopathic in most patients. The commonest identifiable cause, in some 20% of patients, is minor trauma to the head. The condition can present at any age but reaches a peak in the sixth and seventh decades.
Patients with benign paroxysmal positional vertigo due to involvement of the posterior …