Less talked variants of benign paroxysmal positional vertigo

Area of Science:

• Neurology
• Otolaryngology
• Vestibular Science

Background:

• Benign paroxysmal positional vertigo (BPPV) is the most common vestibular disorder globally.
• The 2015 Barany Society criteria advanced BPPV diagnosis and treatment.
• Uncertainties persist regarding BPPV's clinical features, pathophysiology, and variants.

Purpose of the Study:

• To discuss emerging and controversial syndromes of BPPV.
• To review atypical nystagmus patterns associated with specific canals.
• To highlight persistent geotropic positional nystagmus in BPPV.

Main Methods:

• Literature review and synthesis of current research on BPPV.
• Discussion of controversial BPPV syndromes including anterior canal canalolithiasis and posterior canal cupulolithiasis.
• Analysis of atypical nystagmus presentations and persistent geotropic positional nystagmus.

Main Results:

• Updates on controversial BPPV syndromes like anterior canal canalolithiasis and posterior canal cupulolithiasis.
• Description of atypical nystagmus, including pitch plane changes in horizontal canal BPPV and downbeat nystagmus in posterior canal BPPV.
• Emphasis on persistent geotropic positional nystagmus as an uncommon manifestation.

Conclusions:

• Understanding uncommon BPPV types and manifestations is crucial for advancing BPPV pathomechanisms.
• Differentiating these BPPV variants from central vertigo is essential for accurate clinical management.
• Further research into BPPV pathophysiology will improve diagnostic accuracy and therapeutic strategies.