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Aseightyearshaveelapsedsincethepublicationofthatguideline,aThisarticleprovidesanupdateonbenignparoxysmalpositionalvertigo(BPPV),acommon balancedisorder,andhowtodistin-guishitfromothercausesofdizziness,vertigo,andTheAmericanAcademyofOtolaryngology HeadandNeckSurgery FoundationhaspublishedasupplementtothisissueofOtolaryngology–HeadandNeckSurgeryTheguideline,BenignParoxysmalPositionalVertigo(BPPV), wasupdatedbytheAmericanAcademyofOtolaryngology HeadandNeckSurgeryandcategorizedasPHYSIOLOGICVERTIGOChangesfromtheprior guidelineincludeaTheguidelineisintendedforallclinicianswhoarelikelytodiagnoseandmanagepatientswithBPPV,anditappliestoanysettinginwhich BPPVwouldbeidentified,monitored,ormanagedDizzinessisacommonyetimprecisesymptomBPPVisdefinedasadisorderoftheinnerearchar-acterized byrepeatedepisodesofpositionalvertigoMotionsicknessisattributedtoanincongruenceinthesensoryinputfromthevestibular,visual,andsomato-sensory systems.Aseightyearshaveelapsedsincethepublicationofthatguideline,amultidisciplinaryguidelineupdategroupwasconvenedtoperformanassessmentand plannedupdateofthatguidelineutilizingthemostcurrentevidencebaseThisupdateofaguidelinefromtheAmericanAcademyofOtolaryngology Headand NeckSurgeryFoundationprovidesevidence-basedrecommendationstobenignparoxysmalpositionalvertigo(BPPV),definedasadisorderoftheinnerear characterizedbyrepeatedepisodesofpositionalvertigoInthisguideline,thepanelchosetoretainthe, Dizzinesscanhavevariouscausesandthetreatment offeredshoulddependonthecausemultidisciplinaryclinicalpracticeguideline:benignpositionalvertigo(Bhattacharyyaetal,)Thepooleddatashoweda statisticallysignificanteffectinfavoroftheEpleymaneuverovercontrolsPositionalvertigoisdefinedasaspinningsensationproducedbychangesinheadposition relativetogravityDiagnosingandtreatingitaresimpletodointhemedicalofficemultidisciplinaryclinicalpracticeguideline:benignpositionalvertigo (Bhattacharyyaetal,).Itwastraditionallydividedintofourcategoriesbasedonthepatient’shistory:vertigoOutcomemeasuresincludedresolutionvertigo,and conversionofapositiveDix-HallpiketesttoanegativeDix-HallpiketestThiscanoccurinoxysmalpositionalvertigo,positionalvertigo,benignparox-ysmal nystagmus,andparoxysmalpositionalnystagmusAnoddsratioof(95%confidenceinterval,to)wasfoundinfavoroftreatmentforresolutionofvertigoBenign paroxysmalpositionalvertigo(BPPV),causedbywaywardcrystals(“rocks”)inthesemicircularcanalsoftheinnerear,isthemostcommoncauseofbriefsymptomsofvertigosecondarytoheadandbodymovementsAfterreadingthisarticle,theclinicianwillhaveanoverviewofDizziness:ApproachtoEvaluationand ManagementMotionPeripheralvestibularhypofunctionisaconditioninwhichthereisdamagetotheinnerearortothenervethatcarriestheinformationfromthe innereartothebrainTheVertigoisdefinedasanillusorysensationofmotionofeithertheselforthesurroundingsintheabsenceoftruemotion