RT Journal Article SR Electronic T1 Diagnosis and management of benign paroxysmal positional vertigo (BPPV) JF Canadian Medical Association Journal JO CMAJ FD Canadian Medical Association SP 681 OP 693 VO 169 IS 7 A1 Lorne S. Parnes A1 Sumit K. Agrawal A1 Jason Atlas YR 2003 UL http://www.cmaj.ca/content/169/7/681.abstract AB THERE IS COMPELLING EVIDENCE THAT FREE-FLOATING endolymph particles in the posterior semicircular canal underlie most cases of benign paroxysmal positional vertigo (BPPV). Recent pathological findings suggest that these particles are otoconia, probably displaced from the otolithic membrane in the utricle. They typically settle in the dependent posterior canal and render it sensitive to gravity. Well over 90% of patients can be successfully treated with a simple outpatient manoeuvre that moves the particles back into the utricle. We describe the various techniques for this manoeuvre, plus treatments for uncommon variants of BPPV such as that of the lateral canal. For the rare patient whose BPPV is not responsive to these manoeuvres and has severe symptoms, posterior canal occlusion surgery is a safe and highly effective procedure.