Revisiting BPPV: Incidence and Behavior of Atypical Variants

This retrospective study aimed to evaluate the frequency and clinical characteristics of atypical forms of benign paroxysmal positional vertigo (BPPV), comparing them with the more common typical forms.

Clinical and instrumental data from 139 patients observed at a referral center over a 12-month period were analyzed. Patients were divided into a group with unilateral typical BPPV (82 patients) and a group with atypical forms (57 patients). In both cases, diagnosis was performed through clinical evaluation and observation of nystagmus using wireless binocular video-Frenzel goggles (Nystalyze, Inventis S.R.L., Padua, Italy).

The results showed that typical forms required fewer treatment sessions and repositioning maneuvers to achieve recovery. Moreover, in most typical cases, symptom resolution occurred immediately after the therapeutic maneuver, whereas in atypical forms it was more often observed during follow-up visits.

The authors conclude that, although considered rare, atypical forms are relatively frequent in tertiary referral centers, and that analysis of the nystagmus pattern may help identify the location of the canaliths and guide the most appropriate treatment.

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Andrea Castellucci

Médecin ORL consultant

Le docteur A. Castellucci est consultant ORL à l'Hôpital Santa Maria Nuova à Reggio Emilia en Italie. Il collabore avec le service d'Urgence et de Neurologie pour le traitement des syndromes vestibulaires aigus. De plus, il est auteur et co-auteur d'articles dans des revues et de chapitres de livres dans la littérature nationale et internationale, ainsi que orateur lors de conférences nationales et internationales.

Giacinto Asprella Libonati

Médecin chef ORL

Luigi Califano

Specialist in ENT and Audiology

Specialist in ENT and Audiology, Director of the Audiology Unit at the AORN San Pio Hospital in Benevento; speaker at numerous Italian and international conferences in the field of Audiology and Vestibology; organiser of training courses in Audiology and Vestibology since 2011; author of numerous scientific publications in peer-reviewed journals on Audiology and Vestibology.

Pasquale Malara

Audiovestibology Technician

Master's degree in practical vestibology, Sapienza University of Rome

Dr. Pasquale Malara is an audiometrist and hearing aid specialist at the audiovestibology and vestibular rehabilitation service of CENTROMEDICO in Bellinzona (Italian Switzerland).
He is the author and co-author of articles in national and international literature in the sector as well as a speaker at national conferences.

Salvatore Martellucci

ENT medical director

Salvatore Martellucci is ENT medical director at the Latina Hospital. He deals with the treatment of ear, nose and throat pathologies in adults and children but also with the diagnosis and treatment of sleep apnoea, an increasingly common pathology associated with high cardiovascular risk. In addition to his outpatient activities and endoscopic diagnostics, he performs surgery in hospital and in private practice. Dr. Martellucci's main fields of interest are functional rhino-sinus surgery, cosmetic surgery of the nose, endolaryngeal phonosurgery, snoring and obstructive sleep apnoea surgery. He is a speaker at various congresses, seminars, webinars and author of publications in national and international scientific journals.