Diagnostic Criteria for Benign Paroxysmal Positional Vertigo
- Vertigo associated with a characteristic mixed torsional and vertical nystagmus provoked by the Dix-Hallpike test
- A latency (typically of 1 to 2 seconds) between the completion of the Dix-Hallpike test and the onset of vertigo and nystagmus
- Paroxysmal nature of the provoked vertigo and nystagmus (i.e., an increase and then a decline over a period of 10 to 20 seconds)
- Fatigability (i.e., a reduction in vertigo and nystagmus if the Dix-Hallpike test is repeated)
Common Causes of Vertigo
Otologic disorders
- Benign paroxysmal positional vertigo
- Meniere´s disease (hydrops endolymphayic)
- Vestibular neuronitis (labyrinthitis)
Neurologic disorders
- Migraine-associated dizziness
- Vertebrobasilar insufficiency
- Panic disorders
Dix-Hallpike Maneover for Positional Nystagmus
| Peripheral disorder | Central disorder | |
| Latent period before onset of positional nystagmus | 2 to 20 seconds | None |
| Duration of nystagmus | Less than 1 minute | Greater than 1 minute |
| Fatigability | Fatiguing with repetition | Nonfatiguing |
| Direction of nystagmus | Only one type, usually horizontal/rotatory | May change direction with a given head position |
| Intensity of vertigo | Severe | Less severe, sometimes none |
References:
- Furman JM, Cass SP. Benign paroxysmal positional vertigo. N Engl J Med. 1999 Nov 18;341(21):1590-6. [Medline]
Created: Dic 23, 2005
