Dizziness and a feeling of spinning in the sky when lying down are considered to be paroxysmal benign positional vertigo, also known as otolithiasis. Its because the otolith particles in the balance receptors are dislodged, and as the head position changes and the lymphatic fluid in the inner ear swims, the dislodged otoliths irritate the cell membranes of the semicircular canals, causing the patient to experience dizziness, rotation of vision, and even nausea, vomiting, and sweating in severe cases. During episodes of dizziness, patients can be observed to have rotational fluttering of the eyes. Treatment is mainly by manual repositioning. For patients with more severe otolith attacks who cannot tolerate manual repositioning, they should be given intramuscular fenagin to stop dizziness and vomiting. After the dizziness and vomiting are relieved, the otolith is then repositioned by manipulation to return the dislodged otolith to its original location. Otoliths can be cured by resetting.