Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • specific provoking positions
  • brief duration of vertigo
  • episodic vertigo
  • severe episodes of vertigo
  • sudden onset of vertigo
  • nausea, imbalance, and lightheadedness
  • absence of associated neurological or otological symptoms
  • normal neurological examination
  • positive Dix-Hallpike manoeuvre or positive supine lateral head turn
  • normal otological examination

Other diagnostic factors

  • age >50 years
  • female gender
  • positional vertigo in absence of nystagmus

Risk factors

  • increasing age
  • female sex
  • head trauma
  • vestibular neuronitis
  • labyrinthitis
  • migraines
  • inner ear surgery
  • Meniere's disease
  • otitis media
  • hypertension
  • hyperlipidaemia
  • diabetes
  • vertebrobasilar insufficiency
  • giant cell arteritis
  • osteoporosis
  • intubation
  • habitual lateral head-positioning during bed rest (ipsilateral BPPV)

Diagnostic investigations

1st investigations to order

  • Dix-Hallpike manoeuvre
  • supine lateral head turns
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Lorne S. Parnes

Professor

Departments of Otolaryngology-Head and Neck Surgery and Clinical Neurological Sciences

University of Western Ontario

London

Canada

Disclosures

LSP is an author of a number of references cited in this monograph.

Shahin Nabi

Departments of Otolaryngology-Head and Neck Surgery and Clinical Neurological Sciences

University of Western Ontario

London

Canada

Disclosures

SN declares that he has no competing interests.

Peer reviewers VIEW ALL

Professor and Vice Chairman

Residency Program Director

Dizziness and Balance Center Director

Otolaryngology-Head and Neck Surgery

Washington University School of Medicine

St. Louis

MO

Disclosures

JG is an author of a number of references cited in this monograph.

Associate Professor

Department of Otolaryngology

University of Colorado

Aurora

CO

Disclosures

SPC is an author of a number of references cited in this monograph.

Associate Professor of Otology and Laryngology

Harvard Medical School

Boston

MA

Disclosures

SDR declares that he has no competing interests.

Consultant Otolaryngologist & Honorary Lecturer

Royal Devon & Exeter NHS Foundation Trust

Exeter

UK

Disclosures

MH is the author of one reference cited in this monograph.

Use of this content is subject to our disclaimer