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Benign Positional Vertigo 

Benign Positional Vertigo

Robert W. Baloh

and Kevin A. Kerber


Benign positional vertigo (BPV), also called benign positioning vertigo and benign paroxysmal positional vertigo, is a common inner ear disorder resulting from abnormal stimulation of the semicircular canals (usually the posterior). The direction of the provocative movement and the appearance of the induced eye movements (nystagmus) identify the involved canal(s). The abnormal stimulation is due to the presence of detached otoconia (canaliths) moving in the canal endolymph under the influence of gravity. In order for positional vertigo to occur, two events must happen: (1) otoconia must be dislodged from the utricular macule, and (2) the head must be held in a critical position that allows the otoconia to enter a semicircular canal. BPV is not a disease; rather, it is a syndrome that can have multiple causes of the detached otoconia.

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