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Benign paroxysmal vertigo
Other Resources UpToDate PubMed

Benign paroxysmal vertigo

Contributors: Carolyn Zyloney MD, Jamie Adams MD, Richard L. Barbano MD, PhD
Other Resources UpToDate PubMed

Synopsis

Benign paroxysmal vertigo (BPV) is a disorder of the inner ear causing repeated episodes of sensation of movement with change of head position. It is also known as benign paroxysmal positional vertigo (BPPV). It occurs when otoliths are dislodged from the utricle and migrate to the semicircular canals. The vertigo starts suddenly and typically lasts seconds to minutes. There may be associated nausea and rarely vomiting. The presentation will differ slightly depending on the semicircular canal that is involved. The posterior canal is most frequently affected; however, the horizontal and anterior canals can also be affected. Patients typically have rotary nystagmus toward the affected ear on examination.

BPV is usually idiopathic; however, it can occur secondary to other causes including head trauma. It is the most common cause of vertigo, with an annual incidence of between 10 and 60 per 100 000 people. BPV can occur at any age but is most common in the 50- to 70-year age group and is about twice as common in women than men.

Codes

ICD10CM:
H81.10 – Benign paroxysmal vertigo, unspecified ear

SNOMEDCT:
111541001 – Benign paroxysmal positional vertigo

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Migraine headache
  • Meniere disease
  • Simple / Complex partial seizure
  • Vestibular schwannoma
  • Brain tumor
  • Neurofibromatosis
  • Systemic lupus erythematosus
  • Drug-induced ototoxicity (aminoglycosides, cisplatin, others)
  • Labyrinthine infarction
  • Brain stem stroke
  • Cerebellar stroke
  • Vertebrobasilar insufficiency
  • Labyrinthitis
  • Vestibular neuritis
  • Ramsay-Hunt syndrome
  • Labyrinthine fistula
  • Cholesteatoma
  • Otosclerosis
  • Post-traumatic Vertigo
  • Multiple sclerosis
  • Arnold-Chiari malformation
  • Concussion
  • Syringobulbia

Best Tests

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Management Pearls

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Therapy

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References

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Last Reviewed:10/23/2018
Last Updated:10/30/2019
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Patient Information for Benign paroxysmal vertigo
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Benign paroxysmal vertigo
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A medical illustration showing key findings of Benign paroxysmal vertigo : Nausea, Vomiting, Nystagmus, Vertigo
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