Otolithiasis, i.e., benign paroxysmal positional vertigo, requires the Dix-Hallpike varus test (commonly known as the head-down tilt test), roll test, vestibular function, and imaging tests. 1. The Dix-Hallpike varus test (commonly known as the head-down supine test): It is used to examine benign paroxysmal positional vertigo in the posterior semicircular canal. The patient sits on the examination bed while the head is turned to one side at 45°, after lying down quickly, the head hangs over the edge of the bed at 20° to the ground, observing for 30 seconds or sitting up after the nystagmus disappears, and examining the opposite side in the same way. The main manifestation is transient vertigo and nystagmus when the affected ear is facing down. 2. Rolling test: It is used to examine benign paroxysmal positional vertigo in the horizontal semicircular canal. The patient lies supine on the examination bed, quickly turns his head to one side, and observes for 1 minute or until the nystagmus disappears. The main manifestation is that the patient immediately develops rotational vertigo and horizontal nystagmus. 3. Vestibular function and imaging examination: this examination is a differential examination to distinguish other diseases, such as central vertigo, Meniere’s disease, vestibular neuritis, upper hemianopsia syndrome, etc. In life, if there is a sudden onset of transient vertigo accompanied by nystagmus, nausea, vomiting and other symptoms, it can be considered as otolithiasis. It is recommended to go to the hospital in time, and under the guidance of the doctor to carry out the relevant examination and diagnosis and treatment.