There are many causes of vertigo, both central and peripheral, among which benign paroxysmal positional vertigo (BPPV, also called otolithiasis) is often misdiagnosed as posterior circulation ischemia, characterized by: ① the appearance of vertigo with a latency period of 1 to 40s or immediately after the patient is in an excited head position, often when getting up or falling down; ② nystagmus; treatment is mainly manual repositioning, but mechanical repositioning is also available now. The first and second night after resetting, patients with otoliths should try to lie in the healthy side. Avoid vigorous activities such as playing ball, swimming, etc. within one month after the reset, avoid washing hair after lying down, and keep sufficient sleep. Some patients may feel unstable walking or even slight vertigo for two to three days after the reset, no need to be nervous. Patients should be followed up in the first week after repositioning, and if there is a recurrence or vertigo, repositioning treatment can be done again until the vertigo disappears completely and the Hallpike-Dix test becomes negative. Most patients are completely cured after 1 or 2 treatments, but some patients may have recurrence after several months or years of treatment, which can be repeated with the same method.