Faculty Advisor(s)

Amy J. Litterini



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Good balance requires integration of sensory information from three systems: vestibular, visual and somatosensory. The vestibular portion of the inner ear contains two types of sensory structures that respond to gravity and head movements: semicircular canals and otolith organs. Crystals of calcium carbonate (otoconia) reside in the otolith organs, but can become dislodged and migrate to the semicircular canals, causing symptoms of vertigo. Benign Paroxysmal Positional Vertigo (BPPV), caused by misplaced otoconia in the semicircular canals, is the most common vestibular disorder. Symptoms include dizziness, nausea, nystagmus, brief episodic vertigo during rapid head movements and specific head positions. BPPV is diagnosed with the Dix-Hallpike test and the gold standard treatment is the Epley maneuver, up to 93% effective at resolving BPPV. Persistent symptoms after initial BPPV treatment indicates BPPV treatment failure. 31-61% of patients with BPPV experience non-positional persistent imbalance, known as residual dizziness (RD), the cause of which remains unclear. RD is common among the elderly, causing impaired functional mobility, increased risk of falls, and decreased quality of life. The purpose of this case study was to document the vestibular rehabilitation of a geriatric patient with BPPV treatment failure.

Publication Date



Physical Therapy

Related Materials

The case report paper for this poster can be found here:


Vestibular Rehabilitation For A Geriatric Patient With Benign Paroxysmal Positional Vertigo Treatment Failure: A Case Report
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