Paroxysmal positional nystagmus is the most prevalent peripheral vestibulopathy and has a lifetime frequency of 2.4%. BPPV is characterized by brief attacks of severe vertigo brought on by a change in head position. When minute calcium crystals called otoconia loosened beyond their normal positioning on the utricle, an inside ear sensing organ, it caused hearing loss.

Although paroxysmal positional nystagmus is exceedingly uncommon in infants, it can afflict people of any age, particularly the elderly. The great majority of incidents occur for no apparent cause, with many patients reporting how they were merely getting out of bed one day when the room began to spin.


Paroxysmal positional nystagmus symptoms appear and disappear quickly, usually in much less than a minute. The symptoms include the following:

  • feeling dizzy, nauseous, faint, or weak
  • feeling of whirling
  • unsteadiness or a lack of steadiness
  • feeling of sickness
  • throwing up


Paroxysmal positional nystagmus is diagnosed by getting a thorough patient’s medical history. The doctor diagnoses it by looking for nystagmus, twitching the eyelids when a person has vertigo due to a change in head spot. A diagnostic examination known as the Dix-Hallpike test is used to do this.

First, the patient’s head is tilted 45 degrees to one side when sitting. The patient is then quickly positioned backwards on the examining table, with the head slightly over the edge. This movement can often cause vertigo, and the doctor can examine the patient’s eyes to check if they have the twitching motion of nystagmus. The presence of a positive reaction establishes the existence of BPPV. A brain MRI or CT scan is typically unnecessary.


A simple and effective strategy for treating paroxysmal positional nystagmus is consistently moving the head. It allows them to float out of the semicircular channel. Repeated positioning manoeuvres may be required during the same visit.

The Epley technique, as well as other outpatient physical therapy and training regimens, can aid in the repositioning of crystals in the semicircular channels. Recurrences are common, and repositioning procedures are frequently required.

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