Vertigo (medical)

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Vertigo is a well-recognized medical condition that consists of the illusion of movement, usually of turning. Most often, patients with vertigo "see" the room and world spinning around them, but sometimes that hallucination of movement is centered on the body, instead, and the patient feels as if he or she is spinning within the room or other setting. In severe vertigo, there is often nausea and even vomiting.

Common conditions causing vertigo

Unusual diagnoses causing vertigo

Pathophysiology

Benign positional vertigo

Most cases of benign positional vertigo are due to canaliths or otoliths (calcium carbonate crystals) in the posterior canal that stimulate the cupula.

Diagnosis

Skew deviation (vertical misalignment) suggests a central lesion.[1]

The Dix–Hallpike maneuver can diagnose posterior canal benign paroxysmal positional vertigo.[2]

Treatment

Benign positional vertigo

Clinical practice guidelines by the American Academy of Neurology address the treatment of benign positional vertigo.[2] The guidelines state:

  • Canalith repositioning procedure may treat benign positional vertigo due to the posterior semicircular canal

References

  1. Cnyrim CD, Newman-Toker D, Karch C, Brandt T, Strupp M (2008). "Bedside differentiation of vestibular neuritis from central "vestibular pseudoneuritis"". J. Neurol. Neurosurg. Psychiatr. 79 (4): 458-60. DOI:10.1136/jnnp.2007.123596. PMID 18344397. Research Blogging.
  2. 2.0 2.1 Fife TD, Iverson DJ, Lempert T, et al (May 2008). "Practice Parameter: Therapies for benign paroxysmal positional vertigo (an evidence-based review): Report of the Quality Standards Subcommittee of the American Academy of Neurology". Neurology 70 (22): 2067–74. DOI:10.1212/01.wnl.0000313378.77444.ac. PMID 18505980. Research Blogging.