{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:06:43Z","timestamp":1753891603335,"version":"3.41.2"},"reference-count":109,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T00:00:00Z","timestamp":1744243200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:p>This narrative review aims to present an overview of the symptomatology of chronic multi-canalicular benign paroxysmal positional vertigo (mc-BPPV) from deductive (what is believed to be known), inductive (what is likely), and abductive (hypothetical) perspectives. The purpose is to recognize these symptoms as expressions of an eventual mc-BPPV when they occur in patients with vestibular migraine, whiplash associated disorders (WAD) and other chronic pain disorders. These symptoms are often considered to be biopsychosocial conditions due to a lack of objective findings, that is, the absence of the findings one is looking for\u2014not the absence of findings generally. The symptomatology of mc-BPPV follows a basic neurophysiologic principle: a disorder in one part of the vestibular system often affects the functions of other parts of the vestibular system. In patients with chronic mc-BPPV, abnormal signals are transmitted as afferents to the vestibular nuclei complex; from there, consistently abnormal efferent reflexes are transmitted. These symptoms can include dizziness, visual disturbances, headache, neck pain, temporomandibular joint region pain, other musculoskeletal pain, involuntary movements, tinnitus, temperature disturbance, and cognitive dysfunction. Therefore, it is necessary to consider the possibility of mc-BPPV in patients with vestibular migraine, WAD and other chronic pain disorders.<\/jats:p>","DOI":"10.3389\/fneur.2025.1563295","type":"journal-article","created":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T04:10:52Z","timestamp":1744258252000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Poly-symptomatology of chronic multi-canalicular benign paroxysmal positional vertigo: a deductive, inductive, and abductive narrative review"],"prefix":"10.3389","volume":"16","author":[{"given":"Carsten","family":"Tjell","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenche","family":"Iglebekk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Borenstein","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,4,10]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1016\/j.sjpain.2013.06.004","article-title":"Pain and other symptoms in patients with chronic benign paroxysmal positional vertigo (BPPV)","volume":"4","author":"Iglebekk","year":"2013","journal-title":"Scand J Pain"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.sjpain.2015.02.002","article-title":"Treatment of chronic canalithiasis can be beneficial for patients with vertigo\/dizziness and chronic musculoskeletal pain, including whiplash related pain","volume":"8","author":"Iglebekk","year":"2015","journal-title":"Scand J Pain"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1097\/MAO.0000000000002020","article-title":"Can a chronic BPPV with a history of trauma be the trigger of symptoms in vestibular migraine, Myalgic encephalomyelitis\/chronic fatigue syndrome (ME\/CFS), and whiplash associated disorders (WAD)?","volume":"40","author":"Tjell","year":"2019","journal-title":"Retrospective Cohort Study Otol Neurotol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"954","DOI":"10.1080\/00016480510040146","article-title":"Multiple positional nystagmus suggests multiple canal involvement in benign paroxysmal vertigo","volume":"125","author":"Lopez-Escamez","year":"2005","journal-title":"Acta Otolaryngol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1016\/j.otohns.2005.03.027","article-title":"BPPV and variants: improved treatment results with automated, nystagmus-based repositioning","volume":"133","author":"Nakayama","year":"2005","journal-title":"Otolaryngol Head Neck Surg"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"105","DOI":"10.3233\/VES-150553","article-title":"Benign paroxysmal positional vertigo: Diagnostic criteria","volume":"25","author":"von Brevern","year":"2015","journal-title":"J Vestib Res"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"S47","DOI":"10.1016\/j.otohns.2008.08.022","article-title":"American Academy of Otolaryngology-Head and Neck Surgery Foundation. 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