The Medical journal of Australia
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Benign positional vertigo (BPV) is the most common cause of episodic vertigo. It results from activation of semicircular canal receptors by the movement of calcium carbonate particles (otoconia) which dislodge from the otolith membranes. During changes in head position, the otoconia either float freely within the semicircular canal duct (canalithiasis) or adhere to and move with the cupula of the canal (cupulolithiasis). ⋯ The Dix-Hallpike test is a simple means of confirming the diagnosis in patients presenting with episodic vertigo or imbalance. Audiovestibular tests are only indicated if a symptomatic primary underlying inner ear disease is suspected. In over 80% of patients, BPV can be treated successfully with a single bedside Epley (particle-repositioning) manoeuvre, which can be performed by any medical practitioner.