Patients can, however, turn their heads side to side or put their chins to their chests as much as they choose. Conclusion Successful management of BPPV begins by recognizing how common this disorder can be, particularly in elderly populations, and including it in the differential diagnosis of dizziness or vertigo. The availability of such a safe, noninvasive, and highly effective therapeutic intervention is rare in primary care medicine and underscores the importance of accurate diagnosis and mastering the treatment maneuvers. The attacks last for a few minutes to several hours and are often accompanied by hearing loss and tinnitus in the affected ear. Brain damage, such as that due to trauma, tumors, or stroke, can trigger vertigo accompanied by other neurological symptoms, including blurred vision, disorientation, and facial numbness.
Migraines can trigger episodes of vertigo that last from minutes to hours.
The vertigo may or may not accompany the headaches. Benign paroxysmal positional vertigo can involve not only the posterior semicircular canal, but also, less commonly, the horizontal canal and possibly the anterior canal. Fatigability, or a reduction in vertigo and nystagmus if the Dix-Hallpike test is repeated. Further rotate the head and body until the patient is face down, and maintain this position for 10 to 15 seconds Step D. Keeping the head facing toward the shoulder on the unaffected side, bring the patient to a seated position and keep the head tilted so that the chin points slightly downward. Dr. Furman is professor in the departments of otolaryngology and neurology at the University of Pittsburgh School of Medicine.