Benign Paroxysmal Positional Vertigo - Signs and Symptoms

Signs and Symptoms

• Symptoms
  • Vertigo: Spinning dizziness, which must have a rotational component.
  • Short duration (paroxysmal): Lasts only seconds to minutes
  • Positional in onset: Can only be induced by a change in position.
  • Nausea is often associated
  • Visual disturbance: It may be difficult to read or see during an attack due to associated nystagmus.
  • Pre-syncope (feeling faint) or syncope (fainting) is unusual.
  • Emesis (vomiting) is uncommon but possible.

• Signs
  • Rotatory (torsional) nystagmus, where the top of the eye rotates towards the affected ear in a beating or twitching fashion, which has a latency and can be fatigued (the vertigo should lessen with deliberate repetition of the provoking maneuver).
  • Nystagmus should only last for 30 seconds to one minute.

Patients do not experience other neurological deficits such as numbness or weakness, and if these symptoms are present, a more serious etiology such as posterior circulation stroke or ischemia, must be considered.

The spinning sensation experienced from BPPV is usually triggered by movement of the head, will have a sudden onset, and can last anywhere between a few seconds to several minutes. The most common movements patients report triggering a spinning sensation are tilting their head upwards in order to look at something, and rolling over in bed.