The difference between vestibular paroxysmal vertigo and otoliths: otoliths is benign paroxysmal positional vertigo, and it is enough to identify it by mastering the diagnosis of benign paroxysmal positional vertigo. Firstly, the onset of benign paroxysmal positional vertigo is relatively brief, usually within a minute, and it occurs suddenly when the head position changes, such as when getting up, or when lying down, or when turning over from side to side, while vestibular paroxysmal vertigo does not, it can occur in different positions, such as when standing upright, and the criteria for occurrence are very broad, much larger than benign paroxysmal positional vertigo. positional vertigo is much greater.