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Updated: Apr 27, 2026

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Repositioning maneuvers for benign paroxysmal positional vertigo.

Daniel R Gold1, Laura Morris, Amir Kheradmand

  • 1Department of Neurology, The Johns Hopkins School of Medicine, 600 N Wolfe St, Path 2-210, Baltimore, MD, 21287, USA, Dgold7@jhmi.edu.

Current Treatment Options in Neurology
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Summary
This summary is machine-generated.

Benign paroxysmal positional vertigo (BPPV) is easily diagnosed and effectively treated with repositioning maneuvers. These simple, inexpensive treatments offer high efficacy for various BPPV canal variants.

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Area of Science:

  • Neurology
  • Otolaryngology

Background:

  • Benign paroxysmal positional vertigo (BPPV) is a common and easily diagnosed neurological condition.
  • Effective treatments for BPPV are typically inexpensive and straightforward repositioning maneuvers.

Purpose of the Study:

  • To review the diagnostic ease and treatment efficacy of various maneuvers for benign paroxysmal positional vertigo (BPPV).
  • To compare the effectiveness and applicability of different repositioning techniques for specific BPPV canal variants.

Main Methods:

  • Review of evidence supporting repositioning maneuvers for posterior, horizontal, and anterior canal BPPV.
  • Comparison of Epley, Semont, Gufoni, BBQ roll, and head-hanging maneuvers based on efficacy and ease of performance.

Main Results:

  • Posterior canal BPPV is effectively treated with Epley or Semont maneuvers.
  • Horizontal canal BPPV can be managed with Gufoni or BBQ roll maneuvers, with Gufoni being simpler to perform.
  • Anterior canal BPPV, though rare, may benefit from head-hanging maneuvers with weaker supporting evidence.

Conclusions:

  • Repositioning maneuvers are the cornerstone of BPPV treatment, offering high efficacy and low cost.
  • Treatment choice depends on clinician preference, maneuver complexity, and patient-specific factors.
  • Medications offer only transient symptom relief and do not address the underlying cause of BPPV.