Otolithiasis, or benign paroxysmal positional vertigo (BBPV), is characterized by recurrent brief episodes of vertigo and characteristic nystagmus induced by changes in head position. Nystagmus occurs during otolithic episodes. There are four subtypes according to the hemicircular canal involved, namely, posterior hemicircular canal BBPV, horizontal hemicircular canal BBPV, superior hemicircular canal BBPV, and mixed BBPV. posterior hemicircular canal BBPV is the most common, accounting for about 90% of the cases, followed by horizontal hemicircular canal BBPV, while superior hemicircular canal BBPV and mixed BBPV are very rare. Typical symptoms are sudden transient episodes of vertigo with nystagmus when the head position changes. Posterior hemicircular canal BBPV is induced by rising and lying in bed, forward and backward head tilt, and nystagmus is vertically rotational in direction. Horizontal hemicircular canal BBPV is induced by turning over and turning the head in bed, and the direction of nystagmus is horizontal.