Benign paroxysmal positional vertigo (BPPV) is a paroxysmal transient vertigo induced by a specific change in head position and is the most common vestibular end-organ lesion. It is also commonly referred to as “otolith”. The pathogenesis is the dislodgement of otoliths from the otolith membrane of the ellipsoidal sac into the semicircular canal. The disease is most common in middle-aged and elderly patients, but it can also occur in young people. Some people have no obvious cause for the onset of the disease, but the possible triggers include head trauma, mood swings, and exertion. What are the clinical characteristics of benign paroxysmal positional vertigo? 1. The occurrence of symptoms is often related to a certain head position or postural activity. The symptoms of vertigo appear when the head position is stimulated (such as turning left or right, getting up or having the affected ear down) and may be accompanied by nausea and vomiting. 2. Nystagmus characteristics: To confirm the diagnosis of BPPV, doctors usually have to do a position change test, one is called roll test and the other is called DIX-HALLPIKE test, which is similar to turning over and getting up in bed in our normal life. When rolling over and turning over, horizontal groundward or backward nystagmus will appear; when falling down from a sitting position to an excited head position, a rotational transient fatigue-prone nystagmus will appear. 3. The duration of BPPV may last from hours to weeks, and may last for months or years. The vertigo may be aggravated or relieved periodically, and in severe cases, vertigo may appear when the head is slightly moved, and there may be no discomfort during the interval, or there may be a long period of light-headedness and floating feeling after the vertigo attack.