{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T08:40:06Z","timestamp":1784623206530,"version":"3.55.0"},"reference-count":50,"publisher":"American Speech Language Hearing Association","issue":"3S","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Audiol"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:sec>\n            <jats:title>Purpose:<\/jats:title>\n            <jats:p>Although benign paroxysmal positional vertigo (BPPV) is often considered benign and easily treatable, aberrant cases of persistent BPPV can be challenging to manage. Detailed differential diagnosis is essential as central-, vascular-, and cervical-related etiologies may mirror the presentation of persistent BPPV. In addition, an understanding of alternative noninvasive treatment options is important as persistent BPPV is often refractory to traditional particle repositioning maneuvers (PRMs). This article reviews clinical considerations for persistent BPPV.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Method:<\/jats:title>\n            <jats:p>A case of a 68-year-old male diagnosed with posterior semicircular canal BPPV (PC-BPPV) and received various unsuccessful PRMs treatments is described. His clinical presentation is referenced alongside various possible etiologies to discern the most likely diagnosis. Nonsurgical treatment options for intractable PC-BPPV will also be reviewed.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>BPPV recalcitrant to PRM treatment warrants investigation of other etiologies; however, key elements of the case history and objective examination are helpful for differential diagnosis. Brandt-Daroff exercises may facilitate habituation of symptoms secondary to persistent BPPV. More research is needed to understand the use of multiaxial repositioning chairs for the treatment of intractable BPPV.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1044\/2022_aja-22-00118","type":"journal-article","created":{"date-parts":[[2023,2,9]],"date-time":"2023-02-09T21:04:49Z","timestamp":1675976689000},"page":"674-682","source":"Crossref","is-referenced-by-count":4,"title":["When Particle Repositioning Maneuvers Just Will Not Stick: Clinical Considerations for Persistent Benign Paroxysmal Positional Vertigo"],"prefix":"10.1044","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8010-8684","authenticated-orcid":false,"given":"Evalena","family":"Behr","sequence":"first","affiliation":[{"name":"Section of Audiology, Head &amp; Neck Institute, Cleveland Clinic, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie A.","family":"Honaker","sequence":"additional","affiliation":[{"name":"Section of Audiology, Head &amp; Neck Institute, Cleveland Clinic, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1310","reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.5152\/iao.2021.9434"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0b013e318268d50a"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599814533075"},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-59980300256-0"},{"key":"e_1_3_2_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599816689667"},{"key":"e_1_3_2_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1980.00790320036009"},{"key":"e_1_3_2_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016480500280140"},{"key":"e_1_3_2_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mehy.2012.11.029"},{"key":"e_1_3_2_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0394632017709917"},{"key":"e_1_3_2_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599812454642"},{"key":"e_1_3_2_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mao.0000185044.31276.59"},{"key":"e_1_3_2_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/019459989210700310"},{"key":"e_1_3_2_14_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000313378.77444.ac"},{"key":"e_1_3_2_15_1","volume-title":"Vestibular disorders: A case study approach to diagnosis and treatment","author":"Furman J.","year":"2010","unstructured":"Furman, J. , Cass, S. , & Whitney, S. (2010). Vestibular disorders: A case study approach to diagnosis and treatment. Oxford University Press."},{"issue":"2","key":"e_1_3_2_16_1","first-page":"151","article-title":"The mechanics of benign paroxysmal vertigo","volume":"8","author":"Hall S. F.","year":"1979","unstructured":"Hall, S. F. , Ruby, R. R. , & McClure, J. A. (1979). The mechanics of benign paroxysmal vertigo. The Journal of Otolaryngology, 8(2), 151\u2013158.","journal-title":"The Journal of Otolaryngology"},{"issue":"469","key":"e_1_3_2_17_1","first-page":"666","article-title":"A systematic review of vertigo in primary care","volume":"51","author":"Hanley K.","year":"2001","unstructured":"Hanley, K. , O'Dowd, T. , & Considine, N. (2001). A systematic review of vertigo in primary care. British Journal of General Practice, 51(469), 666\u2013671. https:\/\/bjgp.org\/content\/bjgp\/51\/469\/666.full.pdf","journal-title":"British Journal of General Practice"},{"key":"e_1_3_2_18_1","doi-asserted-by":"publisher","DOI":"10.2522\/ptj.20090071"},{"key":"e_1_3_2_19_1","article-title":"The Epley (canalith repositioning) manoeuvre for benign paroxysmal positional vertigo","volume":"12","author":"Hilton M. P.","year":"2014","unstructured":"Hilton, M. P. , Pinder, D. K. , & Cochrane ENT Group. (2014). The Epley (canalith repositioning) manoeuvre for benign paroxysmal positional vertigo. Cochrane Database of Systematic Reviews, 12. https:\/\/doi.org\/10.1002\/14651858.CD003162.pub3","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_3_2_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000003586"},{"key":"e_1_3_2_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0b013e3181cabd77"},{"key":"e_1_3_2_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2017.12.167"},{"key":"e_1_3_2_23_1","volume-title":"Balance function assessment and management","author":"Jacobson G. P.","year":"2020","unstructured":"Jacobson, G. P. , Shepard, N. T. , Barin, K. , Janky, K. , & McCaslin, D. L. (2020). Balance function assessment and management. Plural."},{"key":"e_1_3_2_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-020-09952-8"},{"key":"e_1_3_2_25_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016489950180360"},{"key":"e_1_3_2_26_1","doi-asserted-by":"publisher","DOI":"10.3233\/VES-190655"},{"key":"e_1_3_2_27_1","doi-asserted-by":"publisher","DOI":"10.3233\/VES-210169"},{"key":"e_1_3_2_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-021-10852-8"},{"key":"e_1_3_2_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2006.04.020"},{"key":"e_1_3_2_30_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348947308200109"},{"key":"e_1_3_2_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2019.04.003"},{"key":"e_1_3_2_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-021-07226-1"},{"issue":"7","key":"e_1_3_2_33_1","first-page":"681","article-title":"Diagnosis and management of benign paroxysmal positional vertigo (BPPV)","volume":"169","author":"Parnes L. S.","year":"2003","unstructured":"Parnes, L. S. , Agrawal, S. K. , & Atlas, J. (2003). Diagnosis and management of benign paroxysmal positional vertigo (BPPV). CMAJ, 169(7), 681\u2013693. https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC202288\/pdf\/20030930s00016p681.pdf","journal-title":"CMAJ"},{"key":"e_1_3_2_34_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348949310200501"},{"key":"e_1_3_2_35_1","doi-asserted-by":"publisher","DOI":"10.3233\/VES-190687"},{"key":"e_1_3_2_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2173-5808(10)70056-0"},{"key":"e_1_3_2_37_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40945-017-0040-x"},{"key":"e_1_3_2_38_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599814536530"},{"key":"e_1_3_2_39_1","doi-asserted-by":"publisher","DOI":"10.1002\/lio2.35"},{"key":"e_1_3_2_40_1","doi-asserted-by":"publisher","DOI":"10.1097\/AUD.0b013e31819f316a"},{"key":"e_1_3_2_41_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000061477.03862.4D"},{"key":"e_1_3_2_42_1","unstructured":"Schappert S. M. (1992). The national ambulatory medical care survey: 1989 summary."},{"key":"e_1_3_2_43_1","doi-asserted-by":"publisher","DOI":"10.1159\/000055734"},{"key":"e_1_3_2_44_1","doi-asserted-by":"publisher","DOI":"10.1159\/000416126"},{"key":"e_1_3_2_45_1","doi-asserted-by":"publisher","DOI":"10.1093\/ptj\/66.10.1548"},{"issue":"3","key":"e_1_3_2_46_1","first-page":"179","article-title":"Benign paroxysmal vertigo: A comparative prospective study of the efficacy of Brandt and Daroff exercises, Semont and Epley maneuver","volume":"122","author":"Soto Varela A.","year":"2001","unstructured":"Soto Varela, A. , Bartual Magro, J. , Santos P\u00e9rez, S. , V\u00e9lez Regueiro, M. , Lechuga Garc\u00eda, R. , P\u00e9rez-Carro R\u00edos, A. , & Caballero, L. (2001). Benign paroxysmal vertigo: A comparative prospective study of the efficacy of Brandt and Daroff exercises, Semont and Epley maneuver. Revue de Laryngologie, Otologie, Rhinologie, 122(3), 179\u2013183.","journal-title":"Revue de Laryngologie, Otologie, Rhinologie"},{"key":"e_1_3_2_47_1","doi-asserted-by":"publisher","DOI":"10.3233\/VES-160589"},{"key":"e_1_3_2_48_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-014-3175-3"},{"key":"e_1_3_2_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otorri.2017.02.007"},{"key":"e_1_3_2_50_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199701000-00018"},{"key":"e_1_3_2_51_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40463-016-0125-7"}],"container-title":["American Journal of Audiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/pubs.asha.org\/doi\/pdf\/10.1044\/2022_AJA-22-00118","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,31]],"date-time":"2024-12-31T18:21:01Z","timestamp":1735669261000},"score":1,"resource":{"primary":{"URL":"https:\/\/pubs.asha.org\/doi\/10.1044\/2022_AJA-22-00118"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11]]},"references-count":50,"journal-issue":{"issue":"3S","published-print":{"date-parts":[[2023,11]]}},"alternative-id":["10.1044\/2022_AJA-22-00118"],"URL":"https:\/\/doi.org\/10.1044\/2022_aja-22-00118","relation":{},"ISSN":["1059-0889","1558-9137"],"issn-type":[{"value":"1059-0889","type":"print"},{"value":"1558-9137","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11]]}}}