[Benign paroxysmal postural vertigo: basis and its therapy in clinical practice]

The theory of canalolithiasis assumes that benign paroxysmal vertigo and nystagmus is due to particles within the semicircular canal which move freely in the endolymph under gravitational forces, thereby deflecting its cupula. According to this theory the particles could be removed from the posterior canal by manoeuvres applying a succession of different head positions. We describe the pathophysiological mechanism of benign paroxysmal vertigo and our experience with one of these manoeuvres, the Semont manoeuvre. The success rate is impressive and the therapy is highly rewarding in a vertigo syndrome which can cause disability in the patients.