Criterios Diagnóstico para Vértigo Posicional Paroxístico Benigno

Diagnostic Criteria for Benign Paroxysmal Positional Vertigo

  • Vertigo associated with a characteristic mixed torsional and vertical nystagmus provoked by the Dix-Hallpike test
  • A latency (typically of 1 to 2 seconds) between the completion of the Dix-Hallpike test and the onset of vertigo and nystagmus
  • Paroxysmal nature of the provoked vertigo and nystagmus (i.e., an increase and then a decline over a period of 10 to 20 seconds)
  • Fatigability (i.e., a reduction in vertigo and nystagmus if the Dix-Hallpike test is repeated)

Common Causes of Vertigo

Otologic disorders

  • Benign paroxysmal positional vertigo
  • Meniere´s disease (hydrops endolymphayic)
  • Vestibular neuronitis (labyrinthitis)

Neurologic disorders

  • Migraine-associated dizziness
  • Vertebrobasilar insufficiency
  • Panic disorders

Dix-Hallpike Maneover for Positional Nystagmus

Peripheral disorder Central disorder
Latent period before onset of positional nystagmus 2 to 20 seconds None
Duration of nystagmus Less than 1 minute Greater than 1 minute
Fatigability Fatiguing with repetition Nonfatiguing
Direction of nystagmus Only one type, usually horizontal/rotatory May change direction with a given head position
Intensity of vertigo Severe Less severe, sometimes none

 

References:

  1. Furman JM, Cass SP. Benign paroxysmal positional vertigo. N Engl J Med. 1999 Nov 18;341(21):1590-6. [Medline]

Created: Dic 23, 2005