Residual dizziness after successful repositioning maneuver in benign paroxysmal positional vertigo: the status of the issue

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Following a successful otolith repositioning maneuver for benign paroxysmal positional vertigo (BPPV), patients often experience residual dizziness, that means completely different disbalance sense characteristics. This phenomenon is usually referred to as residual dizziness (RD). This review article examines predisposing factors for RD, such as vitamin and mineral metabolism disorders and the patient’s psychological characteristics. It presents current pathogenetic concepts of RD based on otolith dysfunction, delayed central adaptation, the preservation of microstructural residual fragments, and psychogenic disturbances. It also discusses currently accepted diagnostic criteria (confirmed successful treatment of BPPV with repositioning maneuvers, complete absence of positional vertigo and objective nystagmus, and a change in the nature of the disbalance sense itself). The recommended approaches to preventing this condition, including vestibular rehabilitation, drug therapy, and correction of metabolic disorders, are described. The need for continued research aimed at finding the most effective therapy for RD is emphasized.