Benign positional vertigo

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Vertigo - positional

The main symptom is a spinning sensation, which:

• Is usually triggered by head movement
• Often starts suddenly
• Lasts a few minutes or less

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)

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.

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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
• Head CT
• Head MRI
• Magnetic resonance angiography of the head
• Warming and cooling the inner ear with water (caloric stimulation) or air to test eye movements

Review Date: 08/03/2010
Reviewed By: David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., and Seth Schwartz, MD, MPH, Otolaryngologist, Virginia Mason Medical Center, Seattle, Washington.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).