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Awareness of benign paroxysmal positional vertigo in central Israel
BMC Neurology, 04/24/09

Pollak L et al. – Results show benign paroxysmal positional vertigo (BPPV) as an under-diagnosed entity.

• Review of referral letters and medical records of 120 BPPV pts treated from 2006-2008 at a single center
• Evaluation for factors that may contribute to missed diagnosis

• Referral diagnosis clustered into 4 groups: BPPV (25.6%), further unspecified vertigo (36.6%), dizziness (27.5%) and other (10%)
• BPPV recognized more frequently by ENT physicians vs other specialists
• BPPV pts correctly diagnosed were significantly younger with shorter symptom duration vs other referral groups
• Pts in distinct referral groups did not differ in presence of autonomic symptoms or history of another serious disease
• Typical BPPV history for all but 11 pts
• Position dependence noted by referring physician only in 55 pts, of whom 31 were correctly assigned as possible BPPV
• Dix-Hallpike test in only 2 pts
• Previous BPPV diagnosis in 32 pts did not influence recognition of BPPV recurrence
• Audiogram and/or brainstem auditory evoked potentials for ~40% of pts before referral
• Electronystagmography in 7.5% of pts before referral
• Brain imaging in 14% of pts before referral

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