Benign positional vertigo

Definition:

Benign positional vertigo is a disorder involving an abnormal sensation of movement that occurs with certain head positions.

Alternative Names:

Vertigo - positional

Causes, incidence, and risk factors:

Benign positional vertigo occurs when there is an abrupt sensation that you are moving or the room around you is moving. This sensation is triggered by head positions such as lying on one side or tipping the head back. Positional vertigo is triggered by the actual position of the head, while in other disorders involving vertigo, the vertigo is triggered by movement of the head.

Vertigo of any type occurs when there is a problem in the vestibular labyrinth (semicircular canals) -- the portion of the inner ear that controls balance.

Symptoms:

Dizziness, or a sensation where you or the room is moving (vertigo)
- Occurs with specific head positions, or with a change in body position
- Usually lessens quickly (less than one minute)

Signs and tests:

Nystagmus (involuntary eye movements) may be present. Examination is otherwise normal.

Differentiation from other causes of vertigo may include:

A head CT
An MRI scan of head
Caloric stimulation (tests eye reflexes)
Electronystagmography
An EEG, evoked auditory potential studies

Treatment:

Usually, no treatment is required. Occasionally, medications such as antihistamines, anticholinergics, and sedative-hypnotics may be prescribed to reduce symptoms of vertigo.

Avoid head positions that cause vertigo. Use caution in occupations where even short episodes of vertigo may be dangerous.

Sometimes, gradually increasing the time spent in positions that cause vertigo causes the inner ear to adjust and decreases the positional vertigo.

Expectations (prognosis):

Benign positional vertigo is uncomfortable, but it is not medically dangerous, and usually improves with time.

Complications:

Positional vertigo may be difficult to distinguish from other disorders of the inner ear.

Calling your health care provider:

Call for an appointment with your health care provider if vertigo develops that has not been evaluated.

Call for an appointment with your health care provider if benign positional vertigo has been diagnosed and symptoms cause disruption of lifestyle, symptoms worsen, or new symptoms develop.

Prevention:

Avoid head positions that trigger positional vertigo.

Review Date: 10/31/2001
Reviewed By: Ashutosh Kacker, M.D., Department of Otolaryngology, New York Presbyterian Hospital, New York, NY. Review provided by VeriMed Healthcare Network.

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