Article Commentary: Response to commentary: Benign paroxysmal position vertigo

Abstract

In November 2008, a multidisciplinary clinical practice guideline on the diagnosis and treatment of benign paroxysmal positional vertigo (BPPV) was published in Otolaryngology Head and Neck Surgery. This guideline makes several evidence-based statements regarding the management of BPPV to facilitate the accurate, efficient, and cost-effective diagnosis and treatment of BPPV. It sets forth specific diagnostic criteria for BPPV and also recommends that clinicians should not routinely obtain radiographic imaging or vestibular testing when the diagnosis of BPPV is made based on history and physical examination. A recent commentary argues that vestibular testing should play a greater role in the diagnosis of BPPV. We review the guideline's recommendations and the rationale behind the recommendation against radiographic and vestibular testing in uncomplicated BPPV.