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Benign positional vertigo, its diagnosis, treatment and mimics
E C Argaet1,2, A P Bradshaw1,2, M S Welgampola1,2
1Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Central Clinical School, University of Sydney, Sydney, Australia.
Clinical Neurophysiology Practice
|June 14, 2019
Summary
Benign positional vertigo (BPV) diagnosis uses patient history and nystagmus patterns during testing. Understanding canalithiasis versus cupulolithiasis guides treatment for this common vestibular disorder.
Area of Science:
- Neurology
- Otolaryngology
- Vestibular Science
Background:
- Benign positional vertigo (BPV) is a common cause of episodic vertigo.
- Diagnosis relies on characteristic patient history and objective findings during positional testing.
Purpose of the Study:
- To review the pathophysiology, diagnosis, and management of BPV subtypes.
- To differentiate BPV from other conditions presenting with similar symptoms.
Main Methods:
- Review of current literature on BPV.
- Analysis of diagnostic criteria including patient history and nystagmus characteristics.
- Evaluation of repositioning maneuvers for different BPV subtypes.
Main Results:
- Nystagmus direction and velocity profiles indicate specific canal involvement and mechanism (canalithiasis or cupulolithiasis).
- Effective repositioning maneuvers exist for various BPV subtypes.
Conclusions:
- Accurate diagnosis of BPV requires careful assessment of positional vertigo history and nystagmus.
- Understanding the underlying mechanism is crucial for selecting appropriate treatment maneuvers.
- Differential diagnosis is important to exclude other causes of vertigo.
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