Benign paroxysmal positional vertigo: The Daily PANCE Blueprint

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Benign paroxysmal positional vertigo: The Daily PANCE Blueprint

A 72-year-old female with a history of hypertension presents to the clinic due to repeated episodes of “dizziness.” She says she feels like the room is spinning when the episode occurs; they last about 40 seconds. She states that the episodes often are triggered when she suddenly sits up, moves her head, or lays down. Which of the following is the most likely diagnosis?

A. Meniere disease
B. Vestibular neuritis
C. Basilar migraines
D. Multiple sclerosis
E. Benign paroxysmal positional vertigo

Answer and topic summary

The answer is E. Benign paroxysmal positional vertigo

Vertigo is a symptom; it is the feeling of spinning even when you are not moving. It can be caused by inner ear dysfunction or dysfunction of the central vestibular system. Causes of peripheral vertigo include vestibular neuritis, labyrinthitis, Meniere disease, benign paroxysmal positional vertigo, aminoglycoside toxicity, etc. Causes of central vertigo include ischemia or hemorrhage of the vertebrobasilar circulation, tumors, migraines, or multiple sclerosis. Neurological symptoms are suggestive of central vertigo. Hearing loss and nausea/emesis are often more common in peripheral vertigo.

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint EENT ⇒ Inner ear (PEARLS) ⇒ Vertigo

Also covered as part of Family Medicine EOR and Emergency Medicine EOR topic lists