1. Etiology and pathogenesis The etiology of benign paroxysmal positional vertigo remains unclear, but it is associated with the following diseases: otolithiasis, which has been confirmed to have granular basophilic material in the posterior semicircular canal jugular crest. Deposits in the roof of the crista (crista parietalis) may be a calcium carbonate crystals of otolithic origin, implanted normally on the balloon and ellipsoidal sac patches of the inner ear, spontaneous metamorphosis of the ellipsoidal sac locus coeruleus, and vagal concussion. It occurs days or weeks after trauma, head trauma, braid flinging injury, etc. It can also be seen after stapes surgery and pneumatic injuries to the inner ear. Ear diseases, middle ear and mastoid infections, labyrinthitis, vestibular neuritis, sudden deafness, and Meniere’s disease in remission may be due to oval saccule infarction, or bilateral asymmetry of vestibular function. The basic pathogenesis of common otolithopathy is that the otolith of the otolith apparatus is dislodged and ectopic into the semicircular canal for some reason, and the otolith swims with the change of the head in a certain direction or position, and at the same time produces abnormal stimulation to the position receptors of the semicircular canal, and then benign paroxysmal positional vertigo occurs. 2. Clinical manifestations Most of them occur when the patient lies to the left or right and turns his head, with a latency period of several seconds; some of them have no latency period, and rotational vertigo appears immediately once the patient turns to the induced position. The vertigo disappears immediately after changing the head position, so the patient is forced to adopt a fixed position for a long time. After the vertigo stops, when the patient sits up again quickly, the vertigo appears again in the opposite direction of the rotation induced by the original side lying. The vertigo lasts for only a few seconds, usually less than 1 minute, and may be accompanied by varying degrees of nausea. The induced vertigo can be reduced in a short time after repeatedly repeating the induced position, which is called “fatigue” in medical science. Because of its fatigue, short duration and absence of tinnitus and deafness, we regard it as benign paroxysmal positional vertigo. The traditional conservative treatment mainly uses vestibular exercise, but it is difficult for patients to tolerate the vertigo caused by repeated head position changes during the exercise. Surgical treatment such as vestibular neurectomy and posterior semicircular canal obstruction is difficult to be accepted by the majority of patients because of its inherent danger and uncertainty of efficacy. In recent years, foreign scholars have designed a new treatment method according to its pathogenesis, namely otolith repositioning method. The basic principle and method is to reset the otolith that is ectopically free in the semicircular canal by applying special head movement to the patient, thus ending benign paroxysmal positional vertigo. 4. Prognosis The disease is self-limiting, which means that some patients can recover from it without treatment in a short time and have a good prognosis. However, there are some cases that persist for many years, and some patients even go to some hospitals for a long time and blindly use many kinds of examination measures, which cost a lot of medical expenses but make it difficult to make a clear diagnosis, and cannot get effective treatment, causing great pain and affecting their normal life and work.