Conclusion:
This case and our simulations emphasize that maneuvers that are designed to induce the movement of displaced otoconia in one specific canal can trigger or treat BPPV in other canals. Our study also raises the question of whether the diagnosis and treatment of BPPV could be improved if clinicians perform the SRT first and then if no nystagmus is elicited, perform the Dix-Hallpike maneuver. Finally, we recommend that clinicians place the head in the correct position for all diagnostic and therapeutic maneuvers, carefully observe and report the direction of the nystagmus, and always consider the location of otoconia within the canals and the possibility of other canals being involved when rendering a canal-specific diagnosis and treatment for BPPV.