Benign paroxysmal positional vertigo.

Benign paroxysmal positional vertigo is a common disorder of the inner ear that should be suspected in all patients with a history of positionally provoked vertigo. The condition appears to be caused by free-floating debris in the posterior semicircular canal. The diagnosis is confirmed by eliciting characteristic symptoms and signs during the Dix-Hallpike test. Although benign paroxysmal positional vertigo is usually a self-limited disorder, treatment with a specific bedside maneuver is effective and can provide the patient immediate and long-lasting relief. Although many patients with positionally provoked vertigo have typical benign paroxysmal positional vertigo, physicians should be aware of nonbenign variants.