Volume 30, Issue 168, February 2026

Benign paroxysmal positional vertigo: an overview of pathophysiology, diagnostic strategies, and therapeutic options

Tomasz Wiśniewski^1♦, Marta Kowalska¹, Anna Mazur¹, Katarzyna Fojcik¹, Wiktoria Ciszewska¹, Wiktor Werenkowicz¹, Zofia Kosztyła-Czech¹, Julia Brodziak¹, Michał Dworak¹, Mateusz Matyja²

¹Medical University of Silesia, Poniatowskiego 15, 40-055 Katowice, Poland
²Specialist Voivodeship Hospital of Saint Barbara No. 5 in Sosnowiec - Trauma Center, Plac Medyków 1, 41-214 Sosnowiec, Poland

^♦Corresponding author
Tomasz Wiśniewski, Wańkowicza 39, 41-404 Mysłowice, Poland

ABSTRACT

Benign paroxysmal positional vertigo (BPPV) is a vestibular disorder and also the most common cause of peripheral vertigo in patients. Due to its high frequency and recurrent nature, BPPV remains a significant clinical issue, especially in otolaryngology and neurology practice. Clinicians can effectively treat it with nonpharmacological interventions; however, it is often underrecognized and affects patients’ quality of life. This article summarizes the key pathophysiological concepts, outlines the most essential positional tests used in diagnosis, and explains how nystagmus patterns guide differentiation between various forms of the disorder, stressing the high success rates of canalith repositioning maneuvers in treatment. Furthermore, the review highlights what is currently known about recurrence, including modifiable factors such as vitamin D deficiency, to encourage proactive management and reassure patients.

Keywords: Benign Paroxysmal Positional Vertigo; BPPV; Vestibular disorders; Repositioning maneuvers; Dix–Hallpike test

Medical Science, 2026, 30, e32ms3779

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DOI: https://doi.org/10.54905/disssi.v30i168.e32ms3779

Published: 15 February 2026