International classification of BPPV
Reviewed by Victor Osei-Lah

In the past few years, the Bárány Society has made great strides in defining and classifying vestibular disorders along the lines of the international classification of diseases. This article addresses the diagnostic criteria for BPPV, the commonest cause of vertigo. The authors addressed the controversy surrounding terminology used to describe the vertigo and nystagmus of BPPV: ‘positional’ vs ‘positioning’. Whereas ‘positioning’ is more accurate, they agreed to preserve ‘positional’ in the definitions because of its ubiquitous usage. The paper reviews the epidemiology, pathophysiology and diagnosis extensively. They do not specifically address treatment. The characteristics of canalolithiasis and cupulolithiasis are well described. For BPPV of each of the three semicircular canals, the authors describe the key features of canalolithiasis and cupulolithiasis and how they should be annotated e.g. posterior canalolithiasis is designated pc-BPPV and the cupulolithiasis type, pc-BPPV-cu. Extensive comments and notes are given to clarify areas of controversy such as the features of apogeotropic and short arm horizontal canal BPPV. The authors emphasised the importance of testing for multi-canal BPPV. Guidance is provided on distinguishing BPPV from central disorders. The paper is worth a read for detailed information and references for the epidemiology and pathophysiology of BPPV. 

Benign paroxysmal positional vertigo: Diagnostic criteria.
Von Brevern M, Bertholon P, Brandt T, et al.
JOURNAL OF VESTIBULAR RESEARCH
2015;25:105-17.