Benign paroxysmal positional vertigo: Pathophysiology, Causes, Canal Variants and Treatment

Benign paroxysmal positional vertigo is the most common cause of recurrent vertigo which last for a few seconds usually managed head positioning maneuvers. The most common form of BPPV occurs when otoliths from the macula of the utricle fall into the lumen of the posterior semicircular canal responding to the effect of gravity. BPPV appeared to be associated with previous trauma (6.7% of all patients), ipsilateral Meniere’s disease (6.5%/), ipsilateral vestibular neuritis(5.6%),history of BPPV affecting the same ear(5.2%),a severe systemic disease(4.6%) and history otologic surgery(1%). The effectiveness of the maneuvers depending on correct diagnosis of canal affected, cupula involved or not, single or multiple canal affected and sidedness of structures. The important question of whether repeated maneuvers during one session are more effective than just one remains to be examined systematically.