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J Korean Bal Soc > Volume 2(2); 2003 > Article
Journal of the Korean Balance Society 2003;2(2): 187-190.
병력청취에 의한 양성 발작성 체위성 어지럼증의 진단
김병건, 배희준, 구자성, 권오현
을지의과대학 을지병원 신경과학교실
Reliability of history taking in the diagnosis of benign paroxysmal positional vertigo
Byung Kun Kim, Hee Joon Bae, Ja Seong Koo, Oh Hyun Kwon
Department of Neurology, Eulji University School of Medicine, Eulji Hospital, Seoul, Korea. kbk1403@eulji.or.kr
Background and Objectives:   Patients with benign paroxysmal positional vertigo (BPPV) usually have typical history. They usually complain of vertigo that lasting a few seconds to a minute. It usually occurs in the morning after awaking and provoked by typical positional change such as head turning, sitting, and lying down. However, some patients may describe their vertigo in a rather atypical way, so there is no absolute reliability of a diagnosis based on history taking. To evaluate the reliability of a diagnosis based on history taking, we performed prospective studies.
Materials and Methods:   We obtained structured history from all the patients with BPPV. Total of 408 patients were diagnosed as having BPPV. The diagnosis was based on typical findings of vertigo and nystagmus by Dix-Hallpike maneuver and head turning in supine position.
Results:   Duration of vertigo was more than 10 minutes in 22% of patients. Position-precipitating factors were not spontaneously reported by 37%. 16% of patients complained non-spinning vertigo. 38% of patients could not tell the side to which the spell occurs. In 83 cases (20%), it was impossible to diagnose BPPV based upon a typical history.
Conclusion:   We conclude that non-paroxysmal, non-positional vertigo dose not rule out BPPV. The provocation test is mandatory in those complaining of dizziness regardless of history since BPPV can be quickly diagnosed by provocation test and easily treated.
Keywords: paroxysmal vertigo; positional vertigo; medical history taking; diagnosis
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