The BPPV-SQ: Development and Clinical Evaluation of a Brief Screening Questionnaire for Benign Paroxysmal Positional Vertigo

Background: Benign paroxysmal positional vertigo (BPPV) is the most common cause of peripheral vertigo and is diagnosed clinically, yet many patients initially present in primary care. Early identification may optimize referral and management. Objective: To perform a pilot Phase 1 validation of the BPPV-SQ, a brief screening questionnaire designed for future use in general practice, assessing its ability to identify BPPV, suggest canal involvement, and support progression to Phase 2 validation. Methods: In this prospective observational study, 108 patients with positional vertigo and no neurological signs were evaluated in a specialist setting. The 7-item dichotomous questionnaire (score 0–3 for diagnostic core) was administered prior to bedside examination, which served as the reference standard. Results: Confirmed BPPV increased with higher scores. Among patients with score 3, BPPV was confirmed in 73.5%, with 69.4% lateralization concordance. Lower scores (0–1) were associated with low confirmation rates (14.3%). Conclusions: In this pilot Phase 1 validation, the BPPV-SQ demonstrated score-dependent diagnostic reliability and acceptable lateralization agreement in high-score patients, supporting progression to Phase 2 validation in primary care.