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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

References:

1. Furman JM, Cass SP. Benign paroxysmal positional vertigo. N Engl J Med. 1999 Nov 18;341(21):1590-6. [Medline]

Created: Dic 23, 2005