Atypical forms and differential diagnosis

In the area of benign paroxysmal positioning vertigo (BPPV) a typical form is usually explained by a cupulo or canalithiasis model in one of the semicircular canals. Atypical BPPV is more frequently associated with peripheral disease, but in some cases CNS structural abnormalities must be ruled out. Among the atypical features there are very frequent recurrences, and unexpected unresponsiveness to therapy must be taken into account. In this paper we describe the many possible clinical features of an atypical PPV, the real pathology of atypical forms and the most suitable therapeutic approach. © 2005 Taylor & Francis.