Chapter

Vertigo

pp 251-283

Benign paroxysmal positioning vertigo

  • Thomas BrandtAffiliated withNeurologische Klinik, Klinikum Großhadern, Ludwig-Maximillians-Universität

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Abstract

Benign paroxysmal positioning vertigo (BPPV; also known as positional vertigo) was initially defined by Bárány in 1921. The term itself was coined by Dix and Hallpike (1952). Lanska and Remler (1997) describe in detail the history of BPPV, its original description, the proper eponymic designation for the provocative positioning test, and the steps leading to our current understanding of its pathophysiology. BPPV is the most common cause of vertigo, particularly in the elderly. By age 70, about 30% of all elderly subjects have experienced BPPV at least once. This condition is characterised by brief attacks of rotatory vertigo and concomitant positioning rotatory-linear nystagmus which are elicited by rapid changes in head position relative to gravity. BPPV is a mechanical disorder of the inner ear in which the precipitating positioning of the head causes an abnormal stimulation, usually of the posterior semicircular canal (p-BPPV) of the undermost ear, less frequently of the horizontal semicircular canal (h-BPPV).