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Benign positional vertigo

• Overview
• Symptoms
• Treatment
• Prevention

Alternative Names:

Vertigo - positional

Symptoms:

Vertigo, or a spinning sensation, is the main symptom. The sensation often starts suddenly and can be triggered by head movement. Most often, affected patients complain of the inability to roll in bed or to look up high at something. When severe, the vertigo is often accompanied by vomiting. Patients may also have visual complaints, such as a perception that things are jumping or moving.

Signs and tests:

To make a diagnosis, the doctor will often have you perform a test called the Dix-Hallpike maneuver. In this procedure, the doctor holds your head in a certain position and asks you to lie quickly backward over a table. As you do this, the doctor will look for abnormal eye movements and ask if you experience vertigo. The doctor may use various methods to help evaluate your eye movements.

The results of the rest of the physical exam are otherwise normal. In some cases, differentiation from other causes of vertigo may be needed. In this case, tests may include:

• Head CT
• Head MRI
• Caloric stimulation (tests eye reflexes)
• Electronystagmography
• EEG
• Evoked auditory potential studies

References:

Cummings CW, Flint PW, Haughey BH, et al. Otolaryngology: Head & Neck Surgery. 4th ed. St Louis, Mo; Mosby; 2005:3226.

Rakel P, ed. Conn ’s Current Therapy 2005 . 57th ed. Philadelphia, PA: WB Saunders; 2005:226-227.

Goldman L, Ausiello D. Cecil Textbook of Medicine , 22nd ed. Philadelphia, PA: WB Saunders; 2004:240-241.

• Review Date: 10/17/2005
• Reviewed By: Kevin Sheth, M.D., Department of Neurology, Brigham and Women's Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA. Review provided by VeriMed Healthcare Network.

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