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Investigate the differential diagnoses of recurrent benign paroxysmal positional vertigo from vestibular function and
Ziyi Huang1,2, Bo Liu1,2, Yi Zhang1,2
1Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Acta Oto-Laryngologica
|March 4, 2026
Summary
Recurrent benign paroxysmal positional vertigo (rBPPV) shows distinct vestibular and auditory function patterns. Vestibular evoked myogenic potentials (VEMP) and head impulse tests aid in differentiating rBPPV from other vertigo conditions.
Area of Science:
- Neurology
- Otolaryngology
- Vestibular Science
Background:
- Benign paroxysmal positional vertigo (BPPV) is a common condition that frequently recurs.
- Distinguishing recurrent BPPV (rBPPV) from other positional vertigo disorders presents diagnostic challenges.
Purpose of the Study:
- To investigate vestibular and auditory function in patients with rBPPV compared to those with other recurrent positional vertigo.
- To assess the clinical utility of vestibular function tests in the differential diagnosis of rBPPV.
Main Methods:
- Seventy-four patients with rBPPV or other positional vertigo were evaluated.
- Tests included vestibular evoked myogenic potentials (VEMP), caloric testing, video head impulse test (vHIT), and pure tone audiometry (PTA).
Main Results:
- rBPPV patients exhibited lower ocular VEMP (oVEMP) elicitation rates and reduced bilateral cervical VEMP (cVEMP) responses.
- Abnormalities in caloric and vHIT tests, including reduced vestibulo-ocular reflex (VOR) gain, were more prevalent in rBPPV.
Conclusions:
- Reduced oVEMP elicitation and unilateral cVEMP responses may indicate rBPPV.
- Caloric and vHIT test abnormalities can also be associated with rBPPV.
- Abnormal otolith and semicircular canal function are key indicators for differentiating rBPPV from other vertigo disorders like vestibular migraine.
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