Benign paroxysmal positional vertigo – What are the signs and symptoms, relevant dDx., sequelae, work up, and treatment options?

January 5, 2021 5:13 am Published by

Benign paroxysmal positional vertigo is the most common cause of episodic vertigo, and is thought to be caused by loose, floating debris in the semicircular canals that cause increased neurological signaling from the vestibular system on that side. As a result, vertigo is often brought on by positional change.

Sn. & Sx.:

  • Nausea
  • Acute attacks of transient vertigo lasting seconds to minutes
  • Torsional (rotatory) nystagmus
  • Imbalance
  • Lightheadedness

dDx.:

  • Cholesteatoma
  • Labyrinthitis
  • Vestibular neuronitis
  • Meniere’s disease
  • Ototoxic drugs

Sequelae:

  • Increased likelihood of accidents
  • Hearing loss

Work up:

  • Positive Dix-Hallpike maneuver (torsional nystagmus)
  • Serum chemistry (electrolytes)

Tx.:

  • Typically self-limiting
  • Antiemetics for nausea and vomiting

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This post was written by Omar Rifai