Benign positional vertigo

A. Benign positional vertigo is the most common cause of vertigo. Patients have brief episodes with positional change, typically when turning over in bed, getting out of bed, or bending over and straightening up. It is most common in older people.

B. Diagnosis is by the Dix-Hallpike maneuver: fatigable, torsional, vertical, paroxysmal positional nystagmus resulting from a rapid change from the sitting to the head-hanging position. Benign positional vertigo is caused by calcium within the posterior semicircular canal.

IV. Acute unilateral vestibulopathy is characterized by acute onset of vertigo, nausea, and vomiting lasting for several days, not associated with auditory or neurologic symptoms. Most patients gradually improve over a few weeks, but older patients can have persistent symptoms for months. About half of patients report having had a recent viral upper respiratory tract infection.

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