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HOME > J Korean Bal Soc > Volume 1(1); 2002 > Article
Practical Review Reliability of history taking in the diagnosis of benign paroxysmal positional vertigo

DOI: https://doi.org/
Department of Neurology, Eulji University School of Medicine, Eulji Hospital
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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 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, there is no absolute reliability of a diagnosis based on history. To evaluate the reliability of a diagnosis based on history, we performed prospective studies. Materials and Methods: We obtained structured history from all the patients with dizziness. Total of 274 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 18% of patients. Position-precipitating factors were not spontaneously reported by 38%. 17% of patients complained non-spinning vertigo. 50% of patients could not tell the side to which the spell occurs or they prefer to lie on. In 55 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.


Res Vestib Sci : Research in Vestibular Science