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Clinical diagnosis of benign paroxysmal positional vertigo and vestibular neuritis

Author/s: 
Johns, P, Quinn, J
Date Added: 
February 24, 2020
Journal/Publication: 
Canadian Medical Association Journal
Publisher: 
Joule Inc
Publication Date: 
February 24, 2020
Issue: 
8
Volume: 
192
Pages: 
E182-E186
Type: 
Meta-analyses, Reviews, and Guidelines
Format: 
Article
DOI (1): 
10.1503/cmaj.190334
Keywords 
vertigo
benign paroxysmal positional vertigo
vestibular neuritis
MeSH 
Humans
Neck Pain
Vertigo
Nystagmus
Pathologic
Hearing Tests
Hearing Loss
headache
Benign Paroxysmal Positional Vertigo

RPR Commentary

A nice review of how to differentiate clinically between benign paroxysmal positional vertigo, vestibular neuritis, and central causes of vertigo.

Abstract

KEY POINTS

• Assess patients with vertigo for focal neurologic signs and symptoms, sustained substantial headache or neck pain, inability to stand and spontaneous vertical nystagmus.

• Perform the Dix–Hallpike test only for patients with episodes of vertigo less than 2 minutes and no nystagmus at rest.

• Perform the head impulse, nystagmus and test of skew (HINTS) plus (plus refers to a test of recent hearing loss) examination only for patients with hours or days of constant, ongoing vertigo and nystagmus at rest

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