{"id":2367,"date":"2014-04-21T12:33:37","date_gmt":"2014-04-21T12:33:37","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/ddv\/"},"modified":"2025-05-13T20:27:24","modified_gmt":"2025-05-13T20:27:24","slug":"ddv","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/ddv\/","title":{"rendered":"Differential Diagnosis of Acute Vertigo"},"content":{"rendered":"<div class=\"99c380e4b4a7b96c35d7ddf7dcb434e8\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p><\/p>\n<p style=\"font-weight: 400;\">Benign paroxysmal positional vertigo (BPPV) is characterized by brief\u00a0spinning sensations, usually lasting less than 1 minute, which are generally induced\u00a0by a change in head position with respect to gravity.<\/p>\n<p><!--more--><\/p>\n<p style=\"font-weight: 400;\">BPPV must be distinguished from other, more serious causes of acute or episodic vertigo. A history taking and neurologic examination often\u00a0allow for differentiation among stroke, vestibular neuritis, and BPPV.<\/p>\n<p style=\"font-weight: 400;\"><strong>Differential Diagnosis of Acute Vertigo<\/strong><\/p>\n<table style=\"border-collapse: collapse; width: 100%;\" border=\"1\">\n<tbody>\n<tr>\n<td width=\"115\"><strong>Cause<\/strong><\/td>\n<td width=\"115\"><strong>Onset and Course<\/strong><\/td>\n<td width=\"115\"><strong>Nystagmus<\/strong><\/td>\n<td width=\"115\"><strong>Auditory Symptoms<\/strong><\/td>\n<td width=\"115\"><strong>Other Features<\/strong><\/td>\n<\/tr>\n<tr>\n<td width=\"115\">BPPV*<\/td>\n<td width=\"115\">Recurrent, transient, positional; usually provoked by turning over or getting in and out of bed<\/td>\n<td width=\"115\">Positional, with mixed vertical torsional nystagmus in BPPV involving\u00a0posterior canal and horizontal nystagmus in BPPV involving horizontal canal<\/td>\n<td width=\"115\">None<\/td>\n<td width=\"115\">Recent inciting event possible (e.g., recumbent position at dentist\u2019s office or hair salon, prolonged bed\u00a0rest, head trauma); history of similar episodes<\/td>\n<\/tr>\n<tr>\n<td width=\"115\">Stroke<\/td>\n<td width=\"115\">Spontaneous, usually sustained; may\u00a0be worsened by positional change<\/td>\n<td width=\"115\">Spontaneous, with beating in various\u00a0or changing directions<\/td>\n<td width=\"115\">Occasional<\/td>\n<td width=\"115\">Neurologic symptoms or signs may include headache and vertical misalignment of eyes; results of head impulse test typically normal\u2020<\/td>\n<\/tr>\n<tr>\n<td width=\"115\">Vestibular neuritis<\/td>\n<td width=\"115\">Spontaneous, sustained; may be worsened by positional change<\/td>\n<td width=\"115\">Spontaneous, predominantly horizontal<\/td>\n<td width=\"115\">None<\/td>\n<td width=\"115\">May be preceded by viral illness; results of head-impulse test\u00a0abnormal\u2020<\/td>\n<\/tr>\n<tr>\n<td width=\"115\">Vestibular migraine<\/td>\n<td width=\"115\">Recurrent, spontaneous; duration\u00a0for minutes to hours; may be\u00a0positional<\/td>\n<td width=\"115\">Rare, but when present usually positional<\/td>\n<td width=\"115\">Occasional<\/td>\n<td width=\"115\">Migrainous headaches, motion sickness, family history<\/td>\n<\/tr>\n<tr>\n<td width=\"115\">Meniere\u2019s disease<\/td>\n<td width=\"115\">Recurrent, spontaneous; typical duration for hours<\/td>\n<td width=\"115\">Spontaneous, horizontal<\/td>\n<td width=\"115\">Fluctuating hearing loss, tinnitus<\/td>\n<td width=\"115\">Ear pain, sensation of fullness in ear<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p style=\"font-weight: 400;\">* BPPV denotes benign paroxysmal positional vertigo.<\/p>\n<p style=\"font-weight: 400;\">\u2020 In the head-impulse test, the result is considered abnormal when a corrective movement (saccade) is required to maintain straight-ahead fixation after the head has been rotated to the side.<\/p>\n<p>&nbsp;<\/p>\n<p style=\"font-weight: 400;\"><strong>References:<\/strong><\/p>\n<ol style=\"font-weight: 400;\">\n<li>Kim JS, Zee DS. Clinical practice. Benign paroxysmal positional vertigo. N Engl J Med. 2014 Mar 20;370(12):1138-47\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/24645946\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<li>von Brevern M. Benign paroxysmal positional vertigo. Semin Neurol. 2013 Jul;33(3):204-11.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/24057823\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p style=\"font-weight: 400;\">Created Jul 23, 2014.<\/p>\n<p><\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Sorry, this entry is only available in Espa\u00f1ol.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[139],"tags":[231,593,123,13,932,933,934],"class_list":["post-2367","post","type-post","status-publish","format-standard","hentry","category-otolaryngology","tag-acute","tag-agudo","tag-diagnosis","tag-diagnostico","tag-diferencial","tag-differential","tag-vertigo"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2367","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/comments?post=2367"}],"version-history":[{"count":3,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2367\/revisions"}],"predecessor-version":[{"id":9282,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2367\/revisions\/9282"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/media?parent=2367"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/categories?post=2367"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/tags?post=2367"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}