Benign Paroxysmal Positional Vertigo

Benign Paroxysmal Positional Vertigo (BPPV) is a condition where vertigo (a sensation of spinning) is brought on by changing the position of the head (e.g. looking up, bending down, rolling over in bed)

Diagnosis for Benign Paroxysmal Positional Vertigo

This illustration shows the patient position at the beginning of the Dix-Hallpike test.

This illustration shows the patient position during the Dix-Hallpike test, with the head hanging left.

BPPV is usually diagnosed by the patient's history, examination, and a positive Dix-Hallpike test.  A positive Dix-Hallpike test will elicit a burst of nystagmus, or rapid eye movement, with the patient's neck extended and head rotated toward the affected side while lying in the supine position. The patient will also report symptoms of vertigo.  The direction and duration of nystagmus indicate whether the left or right side is involved and the canal and location within the canal that is affected.  The Roll Test, another test to determine the presence of BPPV, is predominantly used to determine horizontal canal involvement.