Benign paroxysmal positional vertigo after radiologic scanning: a case series

Area of Science:

• Neurology
• Radiology
• Otolaryngology

Background:

• Benign paroxysmal positional vertigo (BPPV) is a common cause of vertigo, particularly in the elderly.
• BPPV symptoms can mimic cerebrovascular events.
• Previous reports have not documented BPPV attacks occurring after radiologic examinations.

Purpose of the Study:

• To report two cases of benign paroxysmal positional vertigo (BPPV) occurring after radiologic imaging.
• To highlight the potential for BPPV following procedures involving prolonged supine positioning.

Main Methods:

• Two patients presented with vertigo, nausea, and vomiting post-radiologic imaging (cranial CT and renal MRA).
• Patients were immobilized in a supine position during imaging.
• Dix-Hallpike tests confirmed rotatory nystagmus; Epley maneuver was performed successfully.

Main Results:

• Both patients experienced acute vertigo and associated symptoms immediately after rapid postural change post-imaging.
• Neurological examinations and lab analyses were normal.
• The Epley maneuver resolved the BPPV in both cases, confirmed by negative Dix-Hallpike tests.

Conclusions:

• Radiologists and clinicians should consider BPPV in patients experiencing vertigo after radiologic procedures.
• Prolonged supine positioning followed by rapid assumption of an upright posture may precipitate BPPV.
• Awareness of this association can lead to timely diagnosis and treatment.