In most, spells sometimes occurred with and sometimes independently. Vertigo typically lasts between 5 minutes and one hour. In the author's practice, the typical patient is a woman of about 35 years of age, who attacks of vertigo combined with headache. The family history is often positive. In the differential are TIAs and paroxysmal vestibular disorders accompanied by headache.
Patients usually respond diet or the usual prophylactic drugs.
Auditory symptoms are rare compared to vestibular symptoms but nevertheless there is good evidence that hearing loss and tinnitus do occur. Benign Paroxysmal Vertigo of Childhood , is a disorder of uncertain origin, possibly migrainous. The differential diagnosis includes Menieres disease , vestibular epilepsy, perilymphatic fistula , posterior fossa tumors, and psychogenic disorders. Vestibular testing can document profound bilateral vestibular loss. Also reported by Baloh and associates, a form exists with episodic vertigo and essential tremor.