Treating a Complex Case of BPPV

Course overview

Benign paroxysmal positional vertigo (BPPV) involving the horizontal canal presents unique diagnostic and treatment challenges, particularly in complex or multi-factorial cases. This case study equips clinicians with the knowledge to identify key clinical features of horizontal canal BPPV, distinguish between canalithiasis and cupulolithiasis, and interpret findings from positional tests such as the Supine Roll Test and Bow & Lean Test. It explores the role of video-oculography in confirming horizontal canal involvement and guides decision-making around the use of specific maneuvers including Gufoni, Zuma, and Kim. Emphasis is also placed on differentiating peripheral from central causes of vertigo, assessing balance and mobility in elderly patients, and applying sound clinical reasoning in cases complicated by comorbidities.