Symptoms:

The main symptom is a spinning sensation, which:

• Is usually triggered by head movement
• Often starts suddenly

Most often, patients say they cannot roll in bed or tilt their head up to look at something.

Other symptoms can include:

• Vision complaints, such as a perception that things are jumping or moving
• Vomiting (in severe cases)

Signs and tests:

To diagnose benign positional vertigo, the health care provider will often perform a test called the Dix-Hallpike maneuver. 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 feel a spinning sensation. The doctor may use various methods to help evaluate your eye movements.

A physical exam is otherwise normal. A complete medical history and careful neurological exam should be done to rule out other reasons for your symptoms. Tests that may be done include:

• EEG
• Electronystagmography
• Evoked auditory potential studies
• Head CT
• Head MRI
• Magnetic resonance angiography of the head
• Warming and cooling the inner ear with water (caloric stimulation) to test eye movements