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Resolution of atypical posterior semicircular canal BPPV: evidence for putative short-arm location
  1. Daniel Ludwig1 and
  2. Michael C Schubert1,2
  1. 1Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD, USA
  2. 2Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, USA
  1. Correspondence to Michael C Schubert, Laboratory of Vestibular NeuroAdaptation; Department of Otolaryngology Head and Neck Surgery, Johns Hopkins University, Baltimore, MD, USA; mschube1{at}


This case demonstrates the successful identification and treatment of atypical posterior semicircular canal benign paroxysmal positional vertigo (BPPV) based on a unique presentation of positional nystagmus, the resultant nystagmus from repositioning manoeuvers, and restored function of the affected semicircular canal. This case illustrates the importance of completing a comprehensive clinical examination and the value for incorporating the video head impulse test as well as adjusting treatment based on testing and patient response when managing variant cases of BPPV.

  • Physiotherapy (rehabilitation)
  • Neurootology
  • Ear, nose and throat/otolaryngology

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  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: DL, MCS. The following authors gave final approval of the manuscript: DL, MCS.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.