Which finding is suggestive of benign paroxysmal positional...

Which finding is suggestive of benign paroxysmal positional vertigo?
(A) It is worse in the evening.
(B) Attacks are precipitated by rolling over in bed.
(C) Hearing loss can be associated.
(D) Nausea is generally not associated.

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Key Concepts

Benign Paroxysmal Positional Vertigo (BPPV)

BPPV is a common vestibular disorder that causes brief episodes of vertigo triggered by changes in head position. It is typically due to dislodged otoliths (calcium carbonate crystals) from the utricle migrating into the semicircular canals, which disrupts the normal flow of endolymph and induces vertigo when the head is moved.

Positional Triggers

The hallmark feature of BPPV is that its episodes are induced by specific head movements, such as rolling over in bed, tilting the head, or looking upward. These movements cause the displaced otoliths to move within the semicircular canals, leading to transient vertigo and often mild nausea.

Differentiation from Other Vestibular Disorders

BPPV is distinguished from other causes of vertigo by the absence of significant auditory symptoms like hearing loss. The episodes are usually very brief and closely linked to head position changes, which helps in differentiating it from other central or peripheral vestibular conditions that may present with additional symptoms or longer durations of vertigo.

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