Diagnostic and therapy gaps in BPPV care: a retrospective analysis and feasibility evaluation across a London NHS trust

Benign paroxysmal positional vertigo (BPPV) is the most prevalent cause of peripheral dizziness, yet it remains poorly assessed and treated in acute settings. Despite the availability of validated bedside tools such as the Dix-Hallpike test (DHT) and canal repositioning manoeuvres (CRM) such as the Epley, diagnostic variability is high, neuroimaging is overused, and vestibular suppressants are frequently prescribed....

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Acute care settings within this NHS trust show significant diagnostic and treatment gaps for BPPV; audiologists and balance clinicians should advocate for standardised BPPV assessment and Epley manoeuvre protocols in acute pathways.

BPPV is highly treatable yet frequently mismanaged in acute settings, leading to unnecessary investigations and prolonged patient suffering — closing these gaps could reduce costs and improve outcomes at scale.

1. 01Retrospective analysis across an NHS trust in London identifies specific gaps in BPPV diagnosis and treatment in acute care.
2. 02BPPV is the most common vestibular disorder and is treatable with particle repositioning manoeuvres (e.g., Epley), yet care gaps persist.
3. 03Study design is retrospective, limiting ability to determine causality or generalisability beyond the trust.
4. 04Findings support the case for implementing standardised BPPV care pathways in acute and emergency settings.
5. 05Published in Frontiers in Neurology, signalling multidisciplinary relevance beyond audiology.

PMID

42952541

DOI

10.3389/fneur.2026.1950987.

Journal

Frontiers in Neurology

Publication type

research_article

Evidence level

4

Population

Patients presenting with BPPV within a London NHS trust acute care setting

Intervention

Retrospective audit of BPPV diagnostic and treatment practices