Differentiating Benign Paroxysmal Positional Vertigo (BPPV) From Vestibular Neuritis-Labyrinthitis BENIGN PAROXYSMAL POSITIONAL VERTIGO • Age: More common in older adults • Hearing loss: None • Frequency of symptoms: Episodic (occurs with certain movements of the head) • Hallpike test: Positive usually on one side only with upbeat and torsional nystagmus and reproduction of vertigo symptoms • Head impulse test: Negative (Note: It is advised not to administer head impulse test in a patient with a clinical history consistent with BPPV.) • Epley maneuver: Highly effective • Recurrence: Frequent VESTIBULAR NEURITIS/LABYRINTHITIS • Age: More common in younger patients • Hearing loss: None in vestibular neuritis; hearing loss in labyrinthitis • Frequency of symptoms: Constant • Hallpike test: Symptoms may be worsened in head-hanging position (Note: It is advised not to administer Hallpike test in a patient with a clinical history consistent with vestibular neuritis or labyrinthitis.) • Head impulse test: Positive (corrective saccade seen) • Epley maneuver: Ineffective • Recurrence: Rare (2 to 11%) #Vertigo #BPPV #Vestibular #Neuritis #Labyrinthitis #diagnosis #neurology #comparison
