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Benign paroxysmal vertigo - Symptoms
Last reviewed: 06.07.2025
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The clinical picture of benign paroxysmal positional vertigo is characterized by the presence of sudden vestibular dizziness (with a sensation of objects rotating around the patient) when changing the position of the head and body. Most often, dizziness occurs in the morning after sleep or at night when turning in bed. Dizziness is characterized by high intensity and lasts no more than one minute. If the patient returns to the original position at the moment of dizziness, then the dizziness stops faster. Also, provoking movements can be throwing the head back and bending down, therefore, most patients, having experimentally determined this effect, try to turn, get out of bed and bend the head slowly and not use the plane of the affected canal,
As a typical peripheral dizziness, an attack of benign paroxysmal positional vertigo may be accompanied by nausea and sometimes vomiting, especially if the dizziness has caused significant anxiety and excitement in the patient, which is accompanied by his tossing and turning with constant changes in the position of the body and head, which, in turn, provokes further attacks.
Benign paroxysmal positional vertigo is characterized by the presence of a specific positional nystagmus, which can be observed during an attack of positional vertigo. Its direction is determined by the localization of freely moving statoconia in a specific semicircular canal to the peculiarities of the organization of the vestibulo-ocular reflex. Most often, benign paroxysmal positional vertigo occurs due to damage to the posterior semicircular canal. Less often, the pathology is localized in the horizontal and anterior canals. Combined pathology of several semicircular canals in one or different ears of one patient is encountered.
Disturbance of balance is not a mandatory symptom of the disease and develops, as a rule, in patients with long-term benign paroxysmal positional vertigo or in the presence of other causes that indirectly worsen balance.
Important for the clinical picture of benign paroxysmal positional vertigo is the complete absence of other neurological and otological symptoms, as well as the absence of hearing changes in patients due to the development of this vertigo.
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