Chapter-05 Posterior Benign Positional Paroxysmal Vertigo

BOOK TITLE: Understanding Benign Paroxysmal Positional Vertigo

1. Casani Augusto Pietro
Publishing Year
Author Affiliations
1. Azienda Ospedaliero-Universitaria Pisana, Pisa, Pisana, Italy
Chapter keywords
Benign positional paroxysmal vertigo, BPPV, posterior semicircular canal, PSC, nystagmus, positional paroxysmal nystagmus, PPNy


Benign positional paroxysmal vertigo (BPPV) represents the most frequently reported vestibular disorder in neuro-otological clinical practice and is the most frequent cause of vertigo with a prevalence in the general population of about 2.4%. This disorder is characterized by the recurrence of brief and violent crises of true vertigo (spinning dizziness) triggered by horizontal and vertical movements of the head. The crises characterized by this disturbance are often repetitive and concentrated in a limited period of time (active phase), with the tendency to reoccur after a symptom-free interval of an unpredictable length (inactive phase); the percentage of recurrences is about 30–50% and the greater part of these, about 80%, manifest during the first year after the end of the treatment. Risk factors for this include female gender, advancing of age, post-traumatic forms, the presence of an associated endolymphatic hydrops, and comorbid conditions such as osteopenia or osteoporosis. The idiopathic and post-traumatic forms of BPPV would seem to involve the posterior semicircular canal (PSC) more frequently compared to other canals that instead are more likely to be associated with a preceding episode of BPPV. Diagnosis and outline of physiopathology, clinical aspects of BPPV of the PSC, diagnostic maneuvers, and physical therapy for BPPV of the PSC have been discussed throughout this chapter.

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