Benign paroxysmal positional vertigo differential diagnosis: Difference between revisions

Latest revision as of 14:05, 29 October 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D.

Overview

BPPV must be differentiated from other diseases that cause vertigo, nystagmus, and hearing problems, such as vestibular neuritis, HSV oticus, Meniere disease, labyrinrhine concussion, perilymphatic fistula, semicircular canal dehiscence syndrome, vestibular paroxysmia, Cogan syndrome, vestibular schwannoma, otitis media, aminoglycoside toxicity, recurrent vestibulopathy, vestibular migraine, epileptic vertigo, multiple sclerosis, brain tumors, cerebellar infarction/hemorrhage, brain stem ischemia, chiari malformation, and Parkinson.

Differentiating BPPV from other Diseases

BPPV must be differentiated from other diseases that cause vertigo, nystagmus, and hearing problems, such as vestibular neuritis, HSV oticus, Meniere disease, labyrinrhine concussion, perilymphatic fistula, semicircular canal dehiscence syndrome, vestibular paroxysmia, Cogan syndrome, vestibular schwannoma, otitis media, aminoglycoside toxicity, recurrent vestibulopathy, vestibular migraine, epileptic vertigo, multiple sclerosis, brain tumors, cerebellar infarction/hemorrhage, brain stem ischemia, chiari malformation, and Parkinson.

Differentiating BPPV from other diseases on the basis of vertigo, nystagmus, and hearing problems

On the basis of vertigo, nystagmus, and hearing problems, BPPV must be differentiated from vestibular neuritis, HSV oticus, Meniere disease, labyrinrhine concussion, perilymphatic fistula, semicircular canal dehiscence syndrome, vestibular paroxysmia, Cogan syndrome, vestibular schwannoma, otitis media, aminoglycoside toxicity, recurrent vestibulopathy, vestibular migraine, epileptic vertigo, multiple sclerosis, brain tumors, cerebellar infarction/hemorrhage, brain stem ischemia, chiari malformation, and Parkinson.

	Symptoms					Lab Findings	Imaging
Diseases	Clinical manifestations					Para-clinical findings		Gold standard	Additional findings
	Symptoms				Physical examination	Para-clinical findings
	Acute onset	Recurrency	Nystagmus	Hearing problems		Lab Findings	Imaging
Peripheral
BPPV ^[1]^[2]^[3]	+	+	+/−	−	+ Dix-Hallpike maneuver	−	−	Dix-Hallpike maneuver	May be associated with nausea, vomiting, and gait instability
Vestibular neuritis ^[4]	+	+/−	+ /− (unilateral)	−	+ Head thrust test	−	−	History/ Physical exam	May be associated with nausea, vomiting, gait instability and previous upper respiratory infection
HSV oticus ^[5]^[6]^[7]^[8]	+	+/−	−	+/−	Taste loss in the front two-thirds of the tongue Acute facial nerve paralysis Vesicles in the ear canal, the tongue, and/or hard palate	+ VZV antibody titres	In MRI with gadolinium dye we may have enhancement of the facial nerve and cranial nerve VIII	History/ Physical exam	May be associated with otalgia, dry mouth, and dry eyes
Meniere disease ^[9]^[10]	+/−	+	+/−	+ (Progressive)	Sensorineural hearing loss	−	In CT scan we may see small or invisible vestibular aqueduct	History/ Physical exam/ Rulling out other diagnoses	May be associated with nausea, vomiting, and tinnitus
Labyrinthine concussion ^[11]^[12]	+	−	−	+	high frequency hearing loss	−	We may see other evidences of head trauma or temporal bone fracture	History/ Physical exam	It happens following blunt head trauma May be associated with dizziness or tinnitus
Perilymphatic fistula ^[13]^[14]^[15]	+/−	+	−	+	Tullio phenomenon	−	CT scan may show fluid around the round window recess	History/ Physical exam/Imaging	Can be a complication of a stapedectomy, head injury, or heavy lifting It may be provoked by sneezing, lifting, straining, coughing, and loud sounds
Semicircular canal dehiscence syndrome ^[16]^[17]	+/−	+	−	+ (air-bone gaps on audiometry)	Tullio phenomenon	−	CT scan may show defect in the arcuate eminence of the superior semicircular canal	History/ Physical exam/Imaging	It may be provoked by Valsalva maneuver, coughing, and sneezing
Vestibular paroxysmia ^[18]^[19]^[20]	+	+	+/− (Induced by hyperventilation)	−	Impaired caloric testing	−	We may see evidence of vestibulocochlear nerve compression on MRI	History/ Physical exam/Imaging	It may be provoked by head turn or other action They respond well to treatment with carbamazepine or oxcarbazepine
Cogan syndrome ^[21]^[22]^[23]	−	+	+/−	+	Interstitial keratitis Oscillopsia Absent vestibular function on caloric test Systemic vasculitis (Aortitis)	Increased ESR and cryoglobulins	In CT scan we may see calcification or soft tissue attenuation obliterating the intralabyrinthine fluid spaces	History/ Physical exam	It may cause Ménière-like attacks
Vestibular schwannoma ^[24]^[25]	−	+	+/−	+	Sensorineural hearing loss + Rinne test Lateralization of Weber test to the normal ear	−	In CT scan we may see erosion, and widening of the internal acoustic meatus Hypointense mass on T1-weighted MRI, and hyperintense mass on T2-weighted MRI	Imaging	Gadolinium-enhanced MRI scan is definitive diagnostic test of acoutic neuroma
Otitis media ^[26]^[27]	+	−	−	+/−	Fever Presence of effusion in the middle ear	Increased acute phase reactants	Opacification of the middle ear	History/ Physical exam	Patient may show other signs and symptoms of upper respiratory infection such az cough, nasal discharge, and fever
Aminoglycoside toxicity ^[28]	+	−	−	+	Oscillopsia	−	−	History/ Physical exam	May be associated with nausea, vomiting, and ataxia It may be irreversible Gentamicin is the most common one
Recurrent vestibulopathy ^[29]^[30]	+	−	−	−	−	−	−	History/ Physical exam	The underlying pathophysiology is unknown It may happen infrequently, every one to two years It may be associated with nausea and vomiting It may overlap with vestibular migraine
Central
Vestibular migrain ^[31]^[32]	–	+	+/−	+/−	History of migraine headaches	−	They may have white-matter hyperintensities (WMHs) on MRI	ICHD-3 criteria	It may be associated with anxiety and depression
Epileptic vertigo ^[33]	−	+	+/−	−	They may experience loss of consciousness and motor/sensory problems	−	−	EEG	They response well to anti-seizure drugs
Multiple sclerosis ^[34]^[35]^[36]	−	+	+/−	−	Lhermitte's sign Spasticity Increased reflexes Internuclear ophthalmoplegia Optic neuritis Gait disturbance	Elevated concentration of CSF oligoclonal bands	Brain atrophy and some contrast enhancing plaques on CT scan Cerebral plaques disseminating in space and time on MRI	History and physical examination Imaging CSF analysis	MS is at least two times more common among women than men The onset of symptoms is mostly between the age of fifteen to forty years, rarely before age fifteen or after age sixty
Brain tumors ^[37]	+/−	+	+	+	Papilledema Focal neurological deficits	Cerebral spinal fluid (CSF) may show cancerous cells	On CT scan most of the brain tumors appears as a hypodense mass lesions On MRI most of the brain tumors appears as a hypointense or isointense on T1-weighted scans, or hyperintense on T2-weighted MRI.	Imaging Biopsy	Patieny may experience headache, seizures, visual changes and changes in personality, mood and concentration
Cerebellar infarction/hemorrhage	+	−	++/−	−	Limb ataxia Gait disturbance Dysarthria	−	Based on the time interval between stroke and imaging we may have different presentations	Imaging	Posterior inferior cerebellar artery is the most common artery that causes vertigo
Brain stem ischemia	+	−	+/−	−	Contralateral body weakness Visual field deficits Oculomotor abnormalities Bulbar findings	−	Based on the time interval between stroke and imaging we may have different presentations For more information click here	Imaging	It may be associated with subclavian steal syndrome
Chiari malformation ^[38]^[39]	−	+	+	−	Tachycardia Pupillary dilatation Impaired gag reflex Impaired coordination	−	In CT scan we may see hydrocephalus, herniated cerebellar tonsils, and a flattened spinal cord In MRI we may see cerebellar tonsillar herniation, wedge shaped tonsils, syringohydromyelia, small posterior fossa, obstructive hydrocephalus, and brainstem anomalies	Imaging	Patient may experience ringing in the ears
Parkinson ^[40]^[41]^[42]	−	+	−	−	Hypomimia Cogwheel rigidity Resting tremor Gait problems Bradykinesia	−	On brain CT scan, Parkinson disease is characterized by cortical and subcortical atrophy MRI findings in Parkinson disease are reduction in T2 relaxation time and reduced iron content in putamen and GPe	History and physical examination	Patients may present with slowness of movement (bradykinesia), shaking hands while they are at rest (resting tremor) and muscle stiffness (rigidity).

ABBREVIATIONS

VZV= Varicella zoster virus, MRI= Magnetic resonance imaging, ESR= Erythrocyte sedimentation rate, EEG= Electroencephalogram, CSF= Cerebrospinal fluid, GPe= Globus pallidus externa, ICHD= International Classification of Headache Disorders

References

↑ Lee SH, Kim JS (June 2010). "Benign paroxysmal positional vertigo". J Clin Neurol. 6 (2): 51–63. doi:10.3988/jcn.2010.6.2.51. PMC 2895225. PMID 20607044.
↑ Chang MB, Bath AP, Rutka JA (October 2001). "Are all atypical positional nystagmus patterns reflective of central pathology?". J Otolaryngol. 30 (5): 280–2. PMID 11771020.
↑ Dorresteijn PM, Ipenburg NA, Murphy KJ, Smit M, van Vulpen JK, Wegner I, Stegeman I, Grolman W (June 2014). "Rapid Systematic Review of Normal Audiometry Results as a Predictor for Benign Paroxysmal Positional Vertigo". Otolaryngol Head Neck Surg. 150 (6): 919–24. doi:10.1177/0194599814527233. PMID 24642523.
↑ Mandalà M, Nuti D, Broman AT, Zee DS (February 2008). "Effectiveness of careful bedside examination in assessment, diagnosis, and prognosis of vestibular neuritis". Arch. Otolaryngol. Head Neck Surg. 134 (2): 164–9. doi:10.1001/archoto.2007.35. PMID 18283159.
↑ Wackym, Phillip A. (1997). "Molecular Temporal Bone Pathology: II. Ramsay Hunt Syndrome (Herpes Zoster Oticus)". The Laryngoscope. 107 (9): 1165–1175. doi:10.1097/00005537-199709000-00003. ISSN 0023-852X.
↑ Zhu, S.; Pyatkevich, Y. (2014). "Ramsay Hunt syndrome type II". Neurology. 82 (18): 1664–1664. doi:10.1212/WNL.0000000000000388. ISSN 0028-3878.
↑ Mishell JH, Applebaum EL (February 1990). "Ramsay-Hunt syndrome in a patient with HIV infection". Otolaryngol Head Neck Surg. 102 (2): 177–9. doi:10.1177/019459989010200215. PMID 2113244.
↑ Tada, Yuichiro; Aoyagi, Masaru; Tojima, Hitoshi; Inamura, Hiroo; Saito, Osamu; Maeyama, Hiroyuki; Kohsyu, Hidehiro; Koike, Yoshio (2009). "Gd-DTPA Enhanced MRI in Ramsay Hunt Syndrome". Acta Oto-Laryngologica. 114 (sup511): 170–174. doi:10.3109/00016489409128326. ISSN 0001-6489.
↑ Watanabe, Isamu (1980). "Ménière's Disease". ORL. 42 (1–2): 20–45. doi:10.1159/000275477. ISSN 1423-0275.
↑ Saeed SR (January 1998). "Fortnightly review. Diagnosis and treatment of Ménière's disease". BMJ. 316 (7128): 368–72. PMC 2665527. PMID 9487176.
↑ Dürrer, J.; Poláčková, J. (1971). "Labyrinthine Concussion". ORL. 33 (3): 185–190. doi:10.1159/000274994. ISSN 1423-0275.
↑ Choi MS, Shin SO, Yeon JY, Choi YS, Kim J, Park SK (April 2013). "Clinical characteristics of labyrinthine concussion". Korean J Audiol. 17 (1): 13–7. doi:10.7874/kja.2013.17.1.13. PMC 3936518. PMID 24653897.
↑ Fox, Eileen J.; Balkany, Thomas J.; Arenberg, Kaufman (1988). "The Tullio Phenomenon and Perilymph Fistula". Otolaryngology–Head and Neck Surgery. 98 (1): 88–89. doi:10.1177/019459988809800115. ISSN 0194-5998.
↑ Casselman JW (February 2002). "Diagnostic imaging in clinical neuro-otology". Curr. Opin. Neurol. 15 (1): 23–30. PMID 11796947.
↑ Seltzer S, McCabe BF (January 1986). "Perilymph fistula: the Iowa experience". Laryngoscope. 96 (1): 37–49. PMID 3941579.
↑ Lempert T, von Brevern M (February 2005). "Episodic vertigo". Curr. Opin. Neurol. 18 (1): 5–9. PMID 15655395.
↑ Watson SR, Halmagyi GM, Colebatch JG (February 2000). "Vestibular hypersensitivity to sound (Tullio phenomenon): structural and functional assessment". Neurology. 54 (3): 722–8. PMID 10680810.
↑ Hufner, K.; Barresi, D.; Glaser, M.; Linn, J.; Adrion, C.; Mansmann, U.; Brandt, T.; Strupp, M. (2008). "Vestibular paroxysmia: Diagnostic features and medical treatment". Neurology. 71 (13): 1006–1014. doi:10.1212/01.wnl.0000326594.91291.f8. ISSN 0028-3878.
↑ Strupp M, von Stuckrad-Barre S, Brandt T, Tonn JC (February 2013). "Teaching neuroimages: Compression of the eighth cranial nerve causes vestibular paroxysmia". Neurology. 80 (7): e77. doi:10.1212/WNL.0b013e318281cc2c. PMID 23400324.
↑ Hüfner K, Barresi D, Glaser M, Linn J, Adrion C, Mansmann U, Brandt T, Strupp M (September 2008). "Vestibular paroxysmia: diagnostic features and medical treatment". Neurology. 71 (13): 1006–14. doi:10.1212/01.wnl.0000326594.91291.f8. PMID 18809837.
↑ Vollertsen RS (May 1990). "Vasculitis and Cogan's syndrome". Rheum. Dis. Clin. North Am. 16 (2): 433–9. PMID 2189159.
↑ Hughes, Gordon B.; Kinney, Sam E.; Barna, Barbara P.; Tomsak, Robert L.; Calabrese, Leonard H. (1983). "Autoimmune reactivity in Cogan's syndrome: A preliminary report". Otolaryngology–Head and Neck Surgery. 91 (1): 24–32. doi:10.1177/019459988309100106. ISSN 0194-5998.
↑ Majoor, M. H. J. M.; Albers, F. W. J.; Casselman, J. W. (2009). "Clinical Relevance of Magnetic Resonance Imaging and Computed Tomography in Cogan's Syndrome". Acta Oto-Laryngologica. 113 (5): 625–631. doi:10.3109/00016489309135875. ISSN 0001-6489.
↑ Robert W. Foley, Shahram Shirazi, Robert M. Maweni, Kay Walsh, Rory McConn Walsh, Mohsen Javadpour & Daniel Rawluk (2017). "Signs and Symptoms of Acoustic Neuroma at Initial Presentation: An Exploratory Analysis". Cureus. 9 (11): e1846. doi:10.7759/cureus.1846. PMID 29348989. Unknown parameter |month= ignored (help)
↑ E. P. Lin & B. T. Crane (2017). "The Management and Imaging of Vestibular Schwannomas". AJNR. American journal of neuroradiology. 38 (11): 2034–2043. doi:10.3174/ajnr.A5213. PMID 28546250. Unknown parameter |month= ignored (help)
↑ "Ear infection - acute: MedlinePlus Medical Encyclopedia".
↑ Rettig E, Tunkel DE (2014). "Contemporary concepts in management of acute otitis media in children". Otolaryngol. Clin. North Am. 47 (5): 651–72. doi:10.1016/j.otc.2014.06.006. PMC 4393005. PMID 25213276.
↑ Ernfors P, Duan ML, ElShamy WM, Canlon B (April 1996). "Protection of auditory neurons from aminoglycoside toxicity by neurotrophin-3". Nat. Med. 2 (4): 463–7. PMID 8597959.
↑ Oh AK, Lee H, Jen JC, Corona S, Jacobson KM, Baloh RW (May 2001). "Familial benign recurrent vertigo". Am. J. Med. Genet. 100 (4): 287–91. PMID 11343320.
↑ Rutka JA, Barber HO (April 1986). "Recurrent vestibulopathy: third review". J Otolaryngol. 15 (2): 105–7. PMID 3712538.
↑ "The International Classification of Headache Disorders: 2nd edition". Cephalalgia. 24 Suppl 1: 9–160. 2004. PMID 14979299.
↑ Absinta M, Rocca MA, Colombo B, Copetti M, De Feo D, Falini A, Comi G, Filippi M (December 2012). "Patients with migraine do not have MRI-visible cortical lesions". J. Neurol. 259 (12): 2695–8. doi:10.1007/s00415-012-6571-x. PMID 22714135.
↑ Tarnutzer AA, Lee SH, Robinson KA, Kaplan PW, Newman-Toker DE (April 2015). "Clinical and electrographic findings in epileptic vertigo and dizziness: a systematic review". Neurology. 84 (15): 1595–604. doi:10.1212/WNL.0000000000001474. PMC 4408281. PMID 25795644.
↑ McDonald WI, Compston A, Edan G, Goodkin D, Hartung HP, Lublin FD, McFarland HF, Paty DW, Polman CH, Reingold SC, Sandberg-Wollheim M, Sibley W, Thompson A, van den Noort S, Weinshenker BY, Wolinsky JS (July 2001). "Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis". Ann. Neurol. 50 (1): 121–7. PMID 11456302.
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↑ Dunniway, Heidi M.; Welling, D. Bradley (2016). "Intracranial Tumors Mimicking Benign Paroxysmal Positional Vertigo". Otolaryngology–Head and Neck Surgery. 118 (4): 429–436. doi:10.1177/019459989811800401. ISSN 0194-5998.
↑ Caldarelli M, Di Rocco C (May 2004). "Diagnosis of Chiari I malformation and related syringomyelia: radiological and neurophysiological studies". Childs Nerv Syst. 20 (5): 332–5. doi:10.1007/s00381-003-0880-4. PMID 15034729.
↑ Sarnat HB (2008). "Disorders of segmentation of the neural tube: Chiari malformations". Handb Clin Neurol. 87: 89–103. doi:10.1016/S0072-9752(07)87006-0. PMID 18809020.
↑ van Wensen, E.; van Leeuwen, R.B.; van der Zaag-Loonen, H.J.; Masius-Olthof, S.; Bloem, B.R. (2013). "Benign paroxysmal positional vertigo in Parkinson's disease". Parkinsonism & Related Disorders. 19 (12): 1110–1112. doi:10.1016/j.parkreldis.2013.07.024. ISSN 1353-8020.
↑ Steiner I, Gomori JM, Melamed E (1985). "Features of brain atrophy in Parkinson's disease. A CT scan study". Neuroradiology. 27 (2): 158–60. PMID 3990948.
↑ Kosta P, Argyropoulou MI, Markoula S, Konitsiotis S (January 2006). "MRI evaluation of the basal ganglia size and iron content in patients with Parkinson's disease". J. Neurol. 253 (1): 26–32. doi:10.1007/s00415-005-0914-9. PMID 15981079.

Template:WH Template:WS

[pmid20607044-1] Lee SH, Kim JS (June 2010). "Benign paroxysmal positional vertigo". J Clin Neurol. 6 (2): 51–63. doi:10.3988/jcn.2010.6.2.51. PMC 2895225. PMID 20607044.

[pmid11771020-2] Chang MB, Bath AP, Rutka JA (October 2001). "Are all atypical positional nystagmus patterns reflective of central pathology?". J Otolaryngol. 30 (5): 280–2. PMID 11771020.

[pmid24642523-3] Dorresteijn PM, Ipenburg NA, Murphy KJ, Smit M, van Vulpen JK, Wegner I, Stegeman I, Grolman W (June 2014). "Rapid Systematic Review of Normal Audiometry Results as a Predictor for Benign Paroxysmal Positional Vertigo". Otolaryngol Head Neck Surg. 150 (6): 919–24. doi:10.1177/0194599814527233. PMID 24642523.

[pmid18283159-4] Mandalà M, Nuti D, Broman AT, Zee DS (February 2008). "Effectiveness of careful bedside examination in assessment, diagnosis, and prognosis of vestibular neuritis". Arch. Otolaryngol. Head Neck Surg. 134 (2): 164–9. doi:10.1001/archoto.2007.35. PMID 18283159.

[Wackym1997-5] Wackym, Phillip A. (1997). "Molecular Temporal Bone Pathology: II. Ramsay Hunt Syndrome (Herpes Zoster Oticus)". The Laryngoscope. 107 (9): 1165–1175. doi:10.1097/00005537-199709000-00003. ISSN 0023-852X.

[ZhuPyatkevich2014-6] Zhu, S.; Pyatkevich, Y. (2014). "Ramsay Hunt syndrome type II". Neurology. 82 (18): 1664–1664. doi:10.1212/WNL.0000000000000388. ISSN 0028-3878.

[pmid2113244-7] Mishell JH, Applebaum EL (February 1990). "Ramsay-Hunt syndrome in a patient with HIV infection". Otolaryngol Head Neck Surg. 102 (2): 177–9. doi:10.1177/019459989010200215. PMID 2113244.

[TadaAoyagi2009-8] Tada, Yuichiro; Aoyagi, Masaru; Tojima, Hitoshi; Inamura, Hiroo; Saito, Osamu; Maeyama, Hiroyuki; Kohsyu, Hidehiro; Koike, Yoshio (2009). "Gd-DTPA Enhanced MRI in Ramsay Hunt Syndrome". Acta Oto-Laryngologica. 114 (sup511): 170–174. doi:10.3109/00016489409128326. ISSN 0001-6489.

[Watanabe1980-9] Watanabe, Isamu (1980). "Ménière's Disease". ORL. 42 (1–2): 20–45. doi:10.1159/000275477. ISSN 1423-0275.

[pmid9487176-10] Saeed SR (January 1998). "Fortnightly review. Diagnosis and treatment of Ménière's disease". BMJ. 316 (7128): 368–72. PMC 2665527. PMID 9487176.

[DürrerPoláčková1971-11] Dürrer, J.; Poláčková, J. (1971). "Labyrinthine Concussion". ORL. 33 (3): 185–190. doi:10.1159/000274994. ISSN 1423-0275.

[pmid24653897-12] Choi MS, Shin SO, Yeon JY, Choi YS, Kim J, Park SK (April 2013). "Clinical characteristics of labyrinthine concussion". Korean J Audiol. 17 (1): 13–7. doi:10.7874/kja.2013.17.1.13. PMC 3936518. PMID 24653897.

[FoxBalkany1988-13] Fox, Eileen J.; Balkany, Thomas J.; Arenberg, Kaufman (1988). "The Tullio Phenomenon and Perilymph Fistula". Otolaryngology–Head and Neck Surgery. 98 (1): 88–89. doi:10.1177/019459988809800115. ISSN 0194-5998.

[pmid11796947-14] Casselman JW (February 2002). "Diagnostic imaging in clinical neuro-otology". Curr. Opin. Neurol. 15 (1): 23–30. PMID 11796947.

[pmid3941579-15] Seltzer S, McCabe BF (January 1986). "Perilymph fistula: the Iowa experience". Laryngoscope. 96 (1): 37–49. PMID 3941579.

[pmid15655395-16] Lempert T, von Brevern M (February 2005). "Episodic vertigo". Curr. Opin. Neurol. 18 (1): 5–9. PMID 15655395.

[pmid10680810-17] Watson SR, Halmagyi GM, Colebatch JG (February 2000). "Vestibular hypersensitivity to sound (Tullio phenomenon): structural and functional assessment". Neurology. 54 (3): 722–8. PMID 10680810.

[HufnerBarresi2008-18] Hufner, K.; Barresi, D.; Glaser, M.; Linn, J.; Adrion, C.; Mansmann, U.; Brandt, T.; Strupp, M. (2008). "Vestibular paroxysmia: Diagnostic features and medical treatment". Neurology. 71 (13): 1006–1014. doi:10.1212/01.wnl.0000326594.91291.f8. ISSN 0028-3878.

[pmid23400324-19] Strupp M, von Stuckrad-Barre S, Brandt T, Tonn JC (February 2013). "Teaching neuroimages: Compression of the eighth cranial nerve causes vestibular paroxysmia". Neurology. 80 (7): e77. doi:10.1212/WNL.0b013e318281cc2c. PMID 23400324.

[pmid18809837-20] Hüfner K, Barresi D, Glaser M, Linn J, Adrion C, Mansmann U, Brandt T, Strupp M (September 2008). "Vestibular paroxysmia: diagnostic features and medical treatment". Neurology. 71 (13): 1006–14. doi:10.1212/01.wnl.0000326594.91291.f8. PMID 18809837.

[pmid2189159-21] Vollertsen RS (May 1990). "Vasculitis and Cogan's syndrome". Rheum. Dis. Clin. North Am. 16 (2): 433–9. PMID 2189159.

[HughesKinney1983-22] Hughes, Gordon B.; Kinney, Sam E.; Barna, Barbara P.; Tomsak, Robert L.; Calabrese, Leonard H. (1983). "Autoimmune reactivity in Cogan's syndrome: A preliminary report". Otolaryngology–Head and Neck Surgery. 91 (1): 24–32. doi:10.1177/019459988309100106. ISSN 0194-5998.

[MajoorAlbers2009-23] Majoor, M. H. J. M.; Albers, F. W. J.; Casselman, J. W. (2009). "Clinical Relevance of Magnetic Resonance Imaging and Computed Tomography in Cogan's Syndrome". Acta Oto-Laryngologica. 113 (5): 625–631. doi:10.3109/00016489309135875. ISSN 0001-6489.

[24] Robert W. Foley, Shahram Shirazi, Robert M. Maweni, Kay Walsh, Rory McConn Walsh, Mohsen Javadpour & Daniel Rawluk (2017). "Signs and Symptoms of Acoustic Neuroma at Initial Presentation: An Exploratory Analysis". Cureus. 9 (11): e1846. doi:10.7759/cureus.1846. PMID 29348989. Unknown parameter |month= ignored (help)

[25] E. P. Lin & B. T. Crane (2017). "The Management and Imaging of Vestibular Schwannomas". AJNR. American journal of neuroradiology. 38 (11): 2034–2043. doi:10.3174/ajnr.A5213. PMID 28546250. Unknown parameter |month= ignored (help)

[urlEar_infection_-_acute:_MedlinePlus_Medical_Encyclopedia-26] "Ear infection - acute: MedlinePlus Medical Encyclopedia".

[pmid25213276-27] Rettig E, Tunkel DE (2014). "Contemporary concepts in management of acute otitis media in children". Otolaryngol. Clin. North Am. 47 (5): 651–72. doi:10.1016/j.otc.2014.06.006. PMC 4393005. PMID 25213276.

[pmid8597959-28] Ernfors P, Duan ML, ElShamy WM, Canlon B (April 1996). "Protection of auditory neurons from aminoglycoside toxicity by neurotrophin-3". Nat. Med. 2 (4): 463–7. PMID 8597959.

[pmid11343320-29] Oh AK, Lee H, Jen JC, Corona S, Jacobson KM, Baloh RW (May 2001). "Familial benign recurrent vertigo". Am. J. Med. Genet. 100 (4): 287–91. PMID 11343320.

[pmid3712538-30] Rutka JA, Barber HO (April 1986). "Recurrent vestibulopathy: third review". J Otolaryngol. 15 (2): 105–7. PMID 3712538.

[pmid14979299-31] "The International Classification of Headache Disorders: 2nd edition". Cephalalgia. 24 Suppl 1: 9–160. 2004. PMID 14979299.

[pmid22714135-32] Absinta M, Rocca MA, Colombo B, Copetti M, De Feo D, Falini A, Comi G, Filippi M (December 2012). "Patients with migraine do not have MRI-visible cortical lesions". J. Neurol. 259 (12): 2695–8. doi:10.1007/s00415-012-6571-x. PMID 22714135.

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@@ Line 1: / Line 1: @@
 __NOTOC__
-[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Astrocytoma]]
+[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Benign_paroxysmal_positional_vertigo]]
 '''For the WikiDoc page for this topic, click [[Benign paroxysmal positional vertigo|here]]'''
@@ Line 6: / Line 6: @@
 ==Overview==
-[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].
+BPPV must be differentiated from other [[Disease|diseases]] that cause [[vertigo]], [[nystagmus]], and [[Hearing impairment|hearing problems]], such as [[Vestibular neuronitis|vestibular neuritis]], [[Herpes simplex virus|HSV]] oticus, [[Ménière's disease|Meniere disease]], labyrinrhine [[concussion]], [[Perilymph fistula|perilymphatic fistula]], [[semicircular canal]] dehiscence syndrome, [[Vestibular system|vestibular]] paroxysmia, [[Cogan syndrome]], [[vestibular schwannoma]], [[otitis media]], [[aminoglycoside]] toxicity, recurrent vestibulopathy, vestibular [[migraine]], [[epileptic]] [[vertigo]], [[multiple sclerosis]], [[Brain tumor|brain tumors]], [[cerebellar infarction]]/[[hemorrhage]], [[brain stem]] [[ischemia]], [[Arnold-Chiari malformation|chiari malformation]], and [[Parkinson's disease|Parkinson]].
-OR
+==Differentiating BPPV from other Diseases==
+BPPV must be differentiated from other [[Disease|diseases]] that cause [[vertigo]], [[nystagmus]], and [[Hearing impairment|hearing problems]], such as [[Vestibular neuronitis|vestibular neuritis]], [[Herpes simplex virus|HSV]] oticus, [[Ménière's disease|Meniere disease]], labyrinrhine [[concussion]], [[Perilymph fistula|perilymphatic fistula]], [[semicircular canal]] dehiscence syndrome, [[Vestibular system|vestibular]] paroxysmia, [[Cogan syndrome]], [[vestibular schwannoma]], [[otitis media]], [[aminoglycoside]] toxicity, recurrent vestibulopathy, vestibular [[migraine]], [[epileptic]] [[vertigo]], [[multiple sclerosis]], [[Brain tumor|brain tumors]], [[cerebellar infarction]]/[[hemorrhage]], [[brain stem]] [[ischemia]], [[Arnold-Chiari malformation|chiari malformation]], and [[Parkinson's disease|Parkinson]].
-[Disease name] must be differentiated from [[differential dx1], [differential dx2], and [differential dx3].
+===Differentiating BPPV from other diseases on the basis of vertigo, nystagmus, and hearing problems===
-==Differentiating [Disease name] from other Diseases==
+On the basis of [[Vertigo MRI|vertigo]], [[nystagmus]], and [[Hearing impairment|hearing problems]], BPPV must be differentiated from  [[Vestibular neuronitis|vestibular neuritis]], [[Herpes simplex virus|HSV]] oticus, [[Ménière's disease|Meniere disease]], labyrinrhine [[concussion]], [[Perilymph fistula|perilymphatic fistula]], [[semicircular canal]] dehiscence syndrome, [[Vestibular system|vestibular]] paroxysmia, [[Cogan syndrome]], [[vestibular schwannoma]], [[otitis media]], [[aminoglycoside]] toxicity, recurrent vestibulopathy, vestibular [[migraine]], [[epileptic]] [[vertigo]], [[multiple sclerosis]], [[Brain tumor|brain tumors]], [[cerebellar infarction]]/[[hemorrhage]], [[brain stem]] [[ischemia]], [[Arnold-Chiari malformation|chiari malformation]], and [[Parkinson's disease|Parkinson]].
-[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].
-OR
-[Disease name] must be differentiated from [differential dx1], [differential dx2], and [differential dx3].
-OR
-As [disease name] manifests in a variety of clinical forms, differentiation must be established in accordance with the particular subtype. [Subtype name 1] must be differentiated from other diseases that cause [clinical feature 1], such as [differential dx1] and [differential dx2]. In contrast, [subtype name 2] must be differentiated from other diseases that cause [clinical feature 2], such as [differential dx3] and [differential dx4].
-===Differentiating [disease name] from other diseases on the basis of [symptom 1], [symptom 2], and [symptom 3]===
-On the basis [symptom 1], [symptom 2], and [symptom 3], [disease name] must be differentiated from [disease 1], [disease 2], [disease 3], [disease 4], [disease 5], and [disease 6].
 {|
 |- style="background: #4479BA; color: #FFFFFF; text-align: center;"
@@ Line 47: / Line 35: @@
 | colspan="10" style="background: #7d7d7d; color: #FFFFFF; text-align: center;" |'''Peripheral'''
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Benign paroxysmal positional vertigo|BPPV]]
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Benign paroxysmal positional vertigo|BPPV]]<br><ref name="pmid20607044">{{cite journal |vauthors=Lee SH, Kim JS |title=Benign paroxysmal positional vertigo |journal=J Clin Neurol |volume=6 |issue=2 |pages=51–63 |date=June 2010 |pmid=20607044 |pmc=2895225 |doi=10.3988/jcn.2010.6.2.51 |url=}}</ref><ref name="pmid11771020">{{cite journal |vauthors=Chang MB, Bath AP, Rutka JA |title=Are all atypical positional nystagmus patterns reflective of central pathology? |journal=J Otolaryngol |volume=30 |issue=5 |pages=280–2 |date=October 2001 |pmid=11771020 |doi= |url=}}</ref><ref name="pmid24642523">{{cite journal |vauthors=Dorresteijn PM, Ipenburg NA, Murphy KJ, Smit M, van Vulpen JK, Wegner I, Stegeman I, Grolman W |title=Rapid Systematic Review of Normal Audiometry Results as a Predictor for Benign Paroxysmal Positional Vertigo |journal=Otolaryngol Head Neck Surg |volume=150 |issue=6 |pages=919–24 |date=June 2014 |pmid=24642523 |doi=10.1177/0194599814527233 |url=}}</ref>
 | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
 | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
@@ Line 53: / Line 42: @@
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |−
 | style="background: #F5F5F5; padding: 5px;" |
-* + Dix-Hallpike maneuver
+* + [[Dix-Hallpike test|Dix-Hallpike maneuver]]
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |−
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |−
 | style="background: #F5F5F5; padding: 5px;" |
-* Dix-Hallpike maneuver
+* [[Dix-Hallpike test|Dix-Hallpike maneuver]]
 | style="background: #F5F5F5; padding: 5px;" |
-* May be associated with nausea, vomiting, and gait instability
+* May be associated with [[nausea]], [[vomiting]], and [[Gait abnormality|gait instability]]
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Vestibular neuronitis|Vestibular neuritis]]
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Vestibular neuronitis|Vestibular neuritis]]<br><ref name="pmid18283159">{{cite journal |vauthors=Mandalà M, Nuti D, Broman AT, Zee DS |title=Effectiveness of careful bedside examination in assessment, diagnosis, and prognosis of vestibular neuritis |journal=Arch. Otolaryngol. Head Neck Surg. |volume=134 |issue=2 |pages=164–9 |date=February 2008 |pmid=18283159 |doi=10.1001/archoto.2007.35 |url=}}</ref>
 | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
 | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
@@ Line 72: / Line 61: @@
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |−
 | style="background: #F5F5F5; padding: 5px;" |
-* History/ Physical exam
+* [[History and Physical examination|History/ Physical exam]]
 | style="background: #F5F5F5; padding: 5px;" |
-* May be associated with nausea, vomiting, gait instability and previous upper respiratory infection
+* May be associated with [[nausea]], [[vomiting]], [[Gait abnormality|gait instability]] and previous [[upper respiratory infection]]
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Ramsay Hunt syndrome type II|HSV oticus]]
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Ramsay Hunt syndrome type II|HSV oticus]]<br><ref name="Wackym1997">{{cite journal|last1=Wackym|first1=Phillip A.|title=Molecular Temporal Bone Pathology: II. Ramsay Hunt Syndrome (Herpes Zoster Oticus)|journal=The Laryngoscope|volume=107|issue=9|year=1997|pages=1165–1175|issn=0023852X|doi=10.1097/00005537-199709000-00003}}</ref><ref name="ZhuPyatkevich2014">{{cite journal|last1=Zhu|first1=S.|last2=Pyatkevich|first2=Y.|title=Ramsay Hunt syndrome type II|journal=Neurology|volume=82|issue=18|year=2014|pages=1664–1664|issn=0028-3878|doi=10.1212/WNL.0000000000000388}}</ref><ref name="pmid2113244">{{cite journal |vauthors=Mishell JH, Applebaum EL |title=Ramsay-Hunt syndrome in a patient with HIV infection |journal=Otolaryngol Head Neck Surg |volume=102 |issue=2 |pages=177–9 |date=February 1990 |pmid=2113244 |doi=10.1177/019459989010200215 |url=}}</ref><ref name="TadaAoyagi2009">{{cite journal|last1=Tada|first1=Yuichiro|last2=Aoyagi|first2=Masaru|last3=Tojima|first3=Hitoshi|last4=Inamura|first4=Hiroo|last5=Saito|first5=Osamu|last6=Maeyama|first6=Hiroyuki|last7=Kohsyu|first7=Hidehiro|last8=Koike|first8=Yoshio|title=Gd-DTPA Enhanced MRI in Ramsay Hunt Syndrome|journal=Acta Oto-Laryngologica|volume=114|issue=sup511|year=2009|pages=170–174|issn=0001-6489|doi=10.3109/00016489409128326}}</ref>
 | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
 | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
@@ Line 82: / Line 72: @@
 | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
 | style="background: #F5F5F5; padding: 5px;" |
-* Taste loss in the front two-thirds of the tongue
+* Taste loss in the front two-thirds of the [[tongue]]
 * [[Acute facial nerve paralysis]]
-* [[Vesicles]] in the [[ear canal]], the tongue, and/or [[hard palate]]
+* [[Vesicles]] in the [[ear canal]], the [[tongue]], and/or [[hard palate]]
-| style="background: #F5F5F5; padding: 5px;" | + VZV antibody titres
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | + [[Varicella zoster virus|VZV]] antibody titres
 | style="background: #F5F5F5; padding: 5px;" |
-* In Magnetic resonance imaging with gadolinium dye we may have enhancement of the facial nerve and cranial nerve VIII
+* In [[Magnetic resonance imaging|MRI]] with [[gadolinium]] dye we may have enhancement of the [[facial nerve]] and [[cranial nerve VIII]]
 | style="background: #F5F5F5; padding: 5px;" |
-* History/ Physical exam
+* [[History and Physical examination|History/ Physical exam]]
 | style="background: #F5F5F5; padding: 5px;" |
-* May be associated with otalgia, dry mouth, and dry eyes
+* May be associated with [[otalgia]], [[dry mouth]], and [[dry eyes]]
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Ménière's disease|Meniere disease]]
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Ménière's disease|Meniere disease]]<br><ref name="Watanabe1980">{{cite journal|last1=Watanabe|first1=Isamu|title=Ménière’s Disease|journal=ORL|volume=42|issue=1-2|year=1980|pages=20–45|issn=1423-0275|doi=10.1159/000275477}}</ref><ref name="pmid9487176">{{cite journal |vauthors=Saeed SR |title=Fortnightly review. Diagnosis and treatment of Ménière's disease |journal=BMJ |volume=316 |issue=7128 |pages=368–72 |date=January 1998 |pmid=9487176 |pmc=2665527 |doi= |url=}}</ref>
 | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
 | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
@@ Line 100: / Line 91: @@
 | style="background: #F5F5F5; padding: 5px; text-align: center;" | + (Progressive)
 | style="background: #F5F5F5; padding: 5px;" |
-* Sensorineural hearing loss
+* [[Sensorineural hearing loss]]
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |−
 | style="background: #F5F5F5; padding: 5px;" |
-* In CTscan we may see small or invisible vestibular aqueduct
+* In [[CT scan]] we may see small or invisible [[vestibular aqueduct]]
 | style="background: #F5F5F5; padding: 5px;" |
-* History/ Physical exam/ Rulling out other diagnoses
+* [[History and Physical examination|History/ Physical exam]]/ Rulling out other diagnoses
 | style="background: #F5F5F5; padding: 5px;" |
-* May be associated with nausea, vomiting, and tinnitus
+* May be associated with [[Nausea and vomiting|nausea]], [[Nausea and vomiting|vomiting]], and [[tinnitus]]
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |Labyrinthine concussion
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |Labyrinthine concussion<br><ref name="DürrerPoláčková1971">{{cite journal|last1=Dürrer|first1=J.|last2=Poláčková|first2=J.|title=Labyrinthine Concussion|journal=ORL|volume=33|issue=3|year=1971|pages=185–190|issn=1423-0275|doi=10.1159/000274994}}</ref><ref name="pmid24653897">{{cite journal |vauthors=Choi MS, Shin SO, Yeon JY, Choi YS, Kim J, Park SK |title=Clinical characteristics of labyrinthine concussion |journal=Korean J Audiol |volume=17 |issue=1 |pages=13–7 |date=April 2013 |pmid=24653897 |pmc=3936518 |doi=10.7874/kja.2013.17.1.13 |url=}}</ref>
 | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |−
@@ Line 115: / Line 107: @@
 | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
 | style="background: #F5F5F5; padding: 5px;" |
-* high frequency hearing loss
+* [[high frequency hearing loss]]
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |−
 | style="background: #F5F5F5; padding: 5px;" |
-* We may see other evidences of head trauma or temporal bone fracture
+* We may see other evidences of [[head trauma]] or [[temporal bone]] [[fracture]]
 | style="background: #F5F5F5; padding: 5px;" |
-* History/ Physical exam
+* [[History and Physical examination|History/ Physical exam]]
 | style="background: #F5F5F5; padding: 5px;" |
-* It happens following blunt head trauma
+* It happens following blunt [[head trauma]]
-* May be associated with dizziness or tinnitus
+* May be associated with [[dizziness]] or [[tinnitus]]
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Perilymphatic fistula]]
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Perilymphatic fistula]]<br><ref name="FoxBalkany1988">{{cite journal|last1=Fox|first1=Eileen J.|last2=Balkany|first2=Thomas J.|last3=Arenberg|first3=Kaufman|title=The Tullio Phenomenon and Perilymph Fistula|journal=Otolaryngology–Head and Neck Surgery|volume=98|issue=1|year=1988|pages=88–89|issn=0194-5998|doi=10.1177/019459988809800115}}</ref><ref name="pmid11796947">{{cite journal |vauthors=Casselman JW |title=Diagnostic imaging in clinical neuro-otology |journal=Curr. Opin. Neurol. |volume=15 |issue=1 |pages=23–30 |date=February 2002 |pmid=11796947 |doi= |url=}}</ref><ref name="pmid3941579">{{cite journal |vauthors=Seltzer S, McCabe BF |title=Perilymph fistula: the Iowa experience |journal=Laryngoscope |volume=96 |issue=1 |pages=37–49 |date=January 1986 |pmid=3941579 |doi= |url=}}</ref>
 | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
 | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
@@ Line 131: / Line 123: @@
 | style="background: #F5F5F5; padding: 5px; text-align: center;" | +
 | style="background: #F5F5F5; padding: 5px;" |
-* Tullio phenomenon
+* [[Tullio phenomenon]]
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |−
 | style="background: #F5F5F5; padding: 5px;" |
-* CT scan may show fluid around the round window recess
+* [[CT scan]] may show fluid around the round window recess
 | style="background: #F5F5F5; padding: 5px;" |
-* History/ Physical exam/Imaging
+* [[History and Physical examination|History/ Physical exam]]/[[Imaging]]
 | style="background: #F5F5F5; padding: 5px;" |
-* Can be a complication of a [[stapedectomy]], head injury, or heavy lifting
+* Can be a complication of a [[stapedectomy]], [[head injury]], or heavy lifting
-* It may be provoked by sneezing, lifting, straining, coughing, and loud sounds
+* It may be provoked by [[Sneeze|sneezing]], lifting, straining, [[Cough|coughing]], and loud sounds
 |-
 | style="background: #DCDCDC; padding: 5px; text-align: center;" |Semicircular canal
-dehiscence syndrome
+dehiscence syndrome<br><ref name="pmid15655395">{{cite journal |vauthors=Lempert T, von Brevern M |title=Episodic vertigo |journal=Curr. Opin. Neurol. |volume=18 |issue=1 |pages=5–9 |date=February 2005 |pmid=15655395 |doi= |url=}}</ref><ref name="pmid10680810">{{cite journal |vauthors=Watson SR, Halmagyi GM, Colebatch JG |title=Vestibular hypersensitivity to sound (Tullio phenomenon): structural and functional assessment |journal=Neurology |volume=54 |issue=3 |pages=722–8 |date=February 2000 |pmid=10680810 |doi= |url=}}</ref>
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |+
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |−
-| style="background: #F5F5F5; padding: 5px; text-align: center;" |+
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
 (air-bone gaps on audiometry)
 | style="background: #F5F5F5; padding: 5px;" |
-* Tullio phenomenon
+* [[Tullio phenomenon]]
 | style="background: #F5F5F5; padding: 5px; text-align: center;" |−
 | style="background: #F5F5F5; padding: 5px;" |
-* CT scan may show defect in the arcuate eminence of the superior semicircular canal
+* [[CT scan]] may show defect in the arcuate eminence of the [[superior semicircular canal]]
 | style="background: #F5F5F5; padding: 5px;" |
-* History/ Physical exam/Imaging
+* [[History and Physical examination|History/ Physical exam]]/[[Imaging]]
 | style="background: #F5F5F5; padding: 5px;" |
-* It may be provoked by Valsalva maneuver, coughing, and sneezing
+* It may be provoked by [[Valsalva maneuver]], [[Cough|coughing]], and [[Sneeze|sneezing]]
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |Vestibular paroxysma
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |Vestibular paroxysmia<br><ref name="HufnerBarresi2008">{{cite journal|last1=Hufner|first1=K.|last2=Barresi|first2=D.|last3=Glaser|first3=M.|last4=Linn|first4=J.|last5=Adrion|first5=C.|last6=Mansmann|first6=U.|last7=Brandt|first7=T.|last8=Strupp|first8=M.|title=Vestibular paroxysmia: Diagnostic features and medical treatment|journal=Neurology|volume=71|issue=13|year=2008|pages=1006–1014|issn=0028-3878|doi=10.1212/01.wnl.0000326594.91291.f8}}</ref><ref name="pmid23400324">{{cite journal |vauthors=Strupp M, von Stuckrad-Barre S, Brandt T, Tonn JC |title=Teaching neuroimages: Compression of the eighth cranial nerve causes vestibular paroxysmia |journal=Neurology |volume=80 |issue=7 |pages=e77 |date=February 2013 |pmid=23400324 |doi=10.1212/WNL.0b013e318281cc2c |url=}}</ref><ref name="pmid18809837">{{cite journal |vauthors=Hüfner K, Barresi D, Glaser M, Linn J, Adrion C, Mansmann U, Brandt T, Strupp M |title=Vestibular paroxysmia: diagnostic features and medical treatment |journal=Neurology |volume=71 |issue=13 |pages=1006–14 |date=September 2008 |pmid=18809837 |doi=10.1212/01.wnl.0000326594.91291.f8 |url=}}</ref>
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
+(Induced by [[hyperventilation]])
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |−
 | style="background: #F5F5F5; padding: 5px;" |
+* Impaired [[Caloric reflex test|caloric testing]]
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |−
 | style="background: #F5F5F5; padding: 5px;" |
+* We may see evidence of [[vestibulocochlear nerve]] compression on [[MRI]]
 | style="background: #F5F5F5; padding: 5px;" |
+* [[History and Physical examination|History/ Physical exam]]/Imaging
 | style="background: #F5F5F5; padding: 5px;" |
+* It may be provoked by head turn or other action
+* They respond well to treatment with [[carbamazepine]] or [[oxcarbazepine]]
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |Cogan syndrome
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Cogan syndrome]]<br><ref name="pmid2189159">{{cite journal |vauthors=Vollertsen RS |title=Vasculitis and Cogan's syndrome |journal=Rheum. Dis. Clin. North Am. |volume=16 |issue=2 |pages=433–9 |date=May 1990 |pmid=2189159 |doi= |url=}}</ref><ref name="HughesKinney1983">{{cite journal|last1=Hughes|first1=Gordon B.|last2=Kinney|first2=Sam E.|last3=Barna|first3=Barbara P.|last4=Tomsak|first4=Robert L.|last5=Calabrese|first5=Leonard H.|title=Autoimmune reactivity in Cogan's syndrome: A preliminary report|journal=Otolaryngology–Head and Neck Surgery|volume=91|issue=1|year=1983|pages=24–32|issn=0194-5998|doi=10.1177/019459988309100106}}</ref><ref name="MajoorAlbers2009">{{cite journal|last1=Majoor|first1=M. H. J. M.|last2=Albers|first2=F. W. J.|last3=Casselman|first3=J. W.|title=Clinical Relevance of Magnetic Resonance Imaging and Computed Tomography in Cogan's Syndrome|journal=Acta Oto-Laryngologica|volume=113|issue=5|year=2009|pages=625–631|issn=0001-6489|doi=10.3109/00016489309135875}}</ref>
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | −
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
-| style="background: #F5F5F5; padding: 5px;" |
 | style="background: #F5F5F5; padding: 5px;" |
+* [[Interstitial keratitis]]
+* [[Oscillopsia]]
+* Absent [[vestibular function]] on [[Caloric reflex test|caloric test]]
+* [[Systemic vasculitis]] ([[Aortitis]])
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |Increased [[ESR]] and  [[cryoglobulins]]
 | style="background: #F5F5F5; padding: 5px;" |
+* In [[CT scan]] we may see [[calcification]] or soft tissue attenuation obliterating the intralabyrinthine fluid spaces
 | style="background: #F5F5F5; padding: 5px;" |
+* [[History and Physical examination|History/ Physical exam]]
 | style="background: #F5F5F5; padding: 5px;" |
+* It may cause [[Ménière's disease|Ménière]]-like attacks
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |Vestibular schwannoma
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Vestibular schwannoma]]<br><ref>{{Cite journal
-| style="background: #F5F5F5; padding: 5px;" |
+ | author = [[Robert W. Foley]], [[Shahram Shirazi]], [[Robert M. Maweni]], [[Kay Walsh]], [[Rory McConn Walsh]], [[Mohsen Javadpour]] & [[Daniel Rawluk]]
-| style="background: #F5F5F5; padding: 5px;" |
+ | title = Signs and Symptoms of Acoustic Neuroma at Initial Presentation: An Exploratory Analysis
-| style="background: #F5F5F5; padding: 5px;" |
+ | journal = [[Cureus]]
-| style="background: #F5F5F5; padding: 5px;" |
+ | volume = 9
-| style="background: #F5F5F5; padding: 5px;" |
+ | issue = 11
+ | pages = e1846
+ | year = 2017
+ | month = November
+ | doi = 10.7759/cureus.1846
+ | pmid = 29348989
+}}</ref><ref>{{Cite journal
+ | author = [[E. P. Lin]] & [[B. T. Crane]]
+ | title = The Management and Imaging of Vestibular Schwannomas
+ | journal = [[AJNR. American journal of neuroradiology]]
+ | volume = 38
+ | issue = 11
+ | pages = 2034–2043
+ | year = 2017
+ | month = November
+ | doi = 10.3174/ajnr.A5213
+ | pmid = 28546250
+}}</ref>
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |−
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
 | style="background: #F5F5F5; padding: 5px;" |
+* [[Sensorineural hearing loss]]
+* + [[Rinne test]]
+* Lateralization of [[Weber test]] to the normal [[ear]]
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |−
 | style="background: #F5F5F5; padding: 5px;" |
+* In [[CT scan]] we may see erosion, and widening of the [[Internal auditory meatus|internal acoustic meatus]]
+* Hypointense [[mass]] on T1-weighted [[MRI]], and hyperintense [[mass]] on T2-weighted [[MRI]]
 | style="background: #F5F5F5; padding: 5px;" |
+* [[Imaging]]
 | style="background: #F5F5F5; padding: 5px;" |
+* [[Gadolinium]]-enhanced [[MRI]] scan is definitive diagnostic test of [[Vestibular schwannoma|acoutic neuroma]]
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |Otitis media
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Otitis media]]<br><ref name="urlEar infection - acute: MedlinePlus Medical Encyclopedia">{{cite web |url=https://www.nlm.nih.gov/medlineplus/ency/article/000638.htm |title=Ear infection - acute: MedlinePlus Medical Encyclopedia |format= |work= |accessdate=}}</ref><ref name="pmid25213276">{{cite journal |vauthors=Rettig E, Tunkel DE |title=Contemporary concepts in management of acute otitis media in children |journal=Otolaryngol. Clin. North Am. |volume=47 |issue=5 |pages=651–72 |year=2014 |pmid=25213276 |pmc=4393005 |doi=10.1016/j.otc.2014.06.006 |url=}}</ref>
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |−
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |−
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
-| style="background: #F5F5F5; padding: 5px;" |
 | style="background: #F5F5F5; padding: 5px;" |
+* Fever
+* Presence of effusion in the [[middle ear]]
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |Increased [[Acute phase reactant|acute phase reactants]]
 | style="background: #F5F5F5; padding: 5px;" |
+* Opacification of the [[middle ear]]
 | style="background: #F5F5F5; padding: 5px;" |
+* [[History and Physical examination|History/ Physical exam]]
 | style="background: #F5F5F5; padding: 5px;" |
+* Patient may show other [[signs]] and [[symptoms]] of [[upper respiratory infection]] such az [[cough]], [[nasal discharge]], and [[fever]]
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |Aminoglycoside toxicity
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |Aminoglycoside toxicity<br><ref name="pmid8597959">{{cite journal |vauthors=Ernfors P, Duan ML, ElShamy WM, Canlon B |title=Protection of auditory neurons from aminoglycoside toxicity by neurotrophin-3 |journal=Nat. Med. |volume=2 |issue=4 |pages=463–7 |date=April 1996 |pmid=8597959 |doi= |url=}}</ref>
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |−
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |−
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
 | style="background: #F5F5F5; padding: 5px;" |
+* [[Oscillopsia]]
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |−
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |−
 | style="background: #F5F5F5; padding: 5px;" |
+* [[History and Physical examination|History/ Physical exam]]
 | style="background: #F5F5F5; padding: 5px;" |
+* May be associated with [[nausea]], [[vomiting]], and [[ataxia]]
+* It may be irreversible
+* [[Gentamicin]] is the most common one
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |Recurrent vestibulopathy
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |Recurrent vestibulopathy<br><ref name="pmid11343320">{{cite journal |vauthors=Oh AK, Lee H, Jen JC, Corona S, Jacobson KM, Baloh RW |title=Familial benign recurrent vertigo |journal=Am. J. Med. Genet. |volume=100 |issue=4 |pages=287–91 |date=May 2001 |pmid=11343320 |doi= |url=}}</ref><ref name="pmid3712538">{{cite journal |vauthors=Rutka JA, Barber HO |title=Recurrent vestibulopathy: third review |journal=J Otolaryngol |volume=15 |issue=2 |pages=105–7 |date=April 1986 |pmid=3712538 |doi= |url=}}</ref>
-| style="background: #F5F5F5; padding: 5px;" | +
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |−
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |−
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |−
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |−
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |−
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |−
 | style="background: #F5F5F5; padding: 5px;" |
+* [[History and Physical examination|History/ Physical exam]]
 | style="background: #F5F5F5; padding: 5px;" |
+* The underlying [[pathophysiology]] is unknown
+* It may happen infrequently, every one to two years
+* It may be associated with [[nausea]] and [[vomiting]]
+* It may overlap with vestibular [[migraine]]
 |- style="background: #4479BA; color: #FFFFFF; text-align: center;"
 ! colspan="10" style="background: #7d7d7d; color: #FFFFFF; text-align: center;" |Central
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |Vestibular migrain
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |Vestibular migrain<br><ref name="pmid14979299">{{cite journal |vauthors= |title=The International Classification of Headache Disorders: 2nd edition |journal=Cephalalgia |volume=24 Suppl 1 |issue= |pages=9–160 |date=2004 |pmid=14979299 |doi= |url=}}</ref><ref name="pmid22714135">{{cite journal |vauthors=Absinta M, Rocca MA, Colombo B, Copetti M, De Feo D, Falini A, Comi G, Filippi M |title=Patients with migraine do not have MRI-visible cortical lesions |journal=J. Neurol. |volume=259 |issue=12 |pages=2695–8 |date=December 2012 |pmid=22714135 |doi=10.1007/s00415-012-6571-x |url=}}</ref>
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
-| style="background: #F5F5F5; padding: 5px;" | +
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
-| style="background: #F5F5F5; padding: 5px;" |
 | style="background: #F5F5F5; padding: 5px;" |
+* History of [[migraine headaches]]
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |−
 | style="background: #F5F5F5; padding: 5px;" |
+* They may have [[White matter|white-matter]] hyperintensities (WMHs) on [[MRI]]
 | style="background: #F5F5F5; padding: 5px;" |
+* ICHD-3 criteria
 | style="background: #F5F5F5; padding: 5px;" |
+* It may be associated with [[anxiety]] and [[depression]]
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |Epileptic vertigo
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |Epileptic vertigo<br><ref name="pmid25795644">{{cite journal |vauthors=Tarnutzer AA, Lee SH, Robinson KA, Kaplan PW, Newman-Toker DE |title=Clinical and electrographic findings in epileptic vertigo and dizziness: a systematic review |journal=Neurology |volume=84 |issue=15 |pages=1595–604 |date=April 2015 |pmid=25795644 |pmc=4408281 |doi=10.1212/WNL.0000000000001474 |url=}}</ref>
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |−
-| style="background: #F5F5F5; padding: 5px;" | +
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |−
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
 | style="background: #F5F5F5; padding: 5px;" |
+* They may experience [[loss of consciousness]] and motor/sensory problems
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |−
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |−
 | style="background: #F5F5F5; padding: 5px;" |
+* [[EEG]]
 | style="background: #F5F5F5; padding: 5px;" |
+* They response well to anti-[[seizure]] drugs
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |Multiple sclerosis
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Multiple sclerosis]]<br><ref name="pmid11456302">{{cite journal |vauthors=McDonald WI, Compston A, Edan G, Goodkin D, Hartung HP, Lublin FD, McFarland HF, Paty DW, Polman CH, Reingold SC, Sandberg-Wollheim M, Sibley W, Thompson A, van den Noort S, Weinshenker BY, Wolinsky JS |title=Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis |journal=Ann. Neurol. |volume=50 |issue=1 |pages=121–7 |date=July 2001 |pmid=11456302 |doi= |url=}}</ref><ref name="pmid3985583">{{cite journal |vauthors=Barrett L, Drayer B, Shin C |title=High-resolution computed tomography in multiple sclerosis |journal=Ann. Neurol. |volume=17 |issue=1 |pages=33–8 |date=January 1985 |pmid=3985583 |doi=10.1002/ana.410170109 |url=}}</ref><ref name="pmid10449103">{{cite journal |vauthors=Fazekas F, Barkhof F, Filippi M, Grossman RI, Li DK, McDonald WI, McFarland HF, Paty DW, Simon JH, Wolinsky JS, Miller DH |title=The contribution of magnetic resonance imaging to the diagnosis of multiple sclerosis |journal=Neurology |volume=53 |issue=3 |pages=448–56 |date=August 1999 |pmid=10449103 |doi= |url=}}</ref>
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |−
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |−
-| style="background: #F5F5F5; padding: 5px;" |
 | style="background: #F5F5F5; padding: 5px;" |
+* [[Lhermitte's sign]]
+* [[Spasticity]]
+* Increased [[reflexes]]
+* [[Internuclear ophthalmoplegia]]
+* [[Optic neuritis]]
+* [[Gait disturbance]]
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |Elevated concentration of [[CSF]] [[oligoclonal bands]]
 | style="background: #F5F5F5; padding: 5px;" |
+* [[Cerebral atrophy|Brain atrophy]] and some [[contrast]] enhancing plaques on [[CT scan]]
+* Cerebral plaques disseminating in space and time on [[MRI scan|MRI]]
 | style="background: #F5F5F5; padding: 5px;" |
+* [[History and Physical examination|History and physical examination]]
+* [[Imaging]]
+* [[CSF analysis]]
 | style="background: #F5F5F5; padding: 5px;" |
+* [[MS]] is at least two times more common among [[women]] than [[men]]
+* The onset of [[symptoms]] is mostly between the age of fifteen to forty years, rarely before age fifteen or after age sixty
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |Brain tumors
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Brain tumor|Brain tumors]]<br><ref name="DunniwayWelling2016">{{cite journal|last1=Dunniway|first1=Heidi M.|last2=Welling|first2=D. Bradley|title=Intracranial Tumors Mimicking Benign Paroxysmal Positional Vertigo|journal=Otolaryngology–Head and Neck Surgery|volume=118|issue=4|year=2016|pages=429–436|issn=0194-5998|doi=10.1177/019459989811800401}}</ref>
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
 | style="background: #F5F5F5; padding: 5px;" |
+* [[Papilledema]]
+* [[Focal neurological deficits]]
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |Cerebral spinal fluid ([[CSF]]) may show cancerous cells
 | style="background: #F5F5F5; padding: 5px;" |
+* On [[CT scan]] most of the [[brain tumors]] appears as a hypodense mass lesions
+* On [[MRI scan|MRI]] most of the [[brain tumors]] appears as a hypointense or isointense on T1-weighted scans, or hyperintense on T2-weighted [[MRI contrast agent|MRI]].
 | style="background: #F5F5F5; padding: 5px;" |
+* [[Imaging]]
+* [[Biopsy forceps|Biopsy]]
 | style="background: #F5F5F5; padding: 5px;" |
+* Patieny may experience  [[headache]], [[seizures]], [[Visual disturbance|visual changes]] and changes in [[personality]], [[mood]] and [[concentration]]
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |Crebellar infarction/hemorrhage
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Cerebellar infarction]]/hemorrhage
-| style="background: #F5F5F5; padding: 5px;" | +
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |−
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | ++/−
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |−
-| style="background: #F5F5F5; padding: 5px;" |
 | style="background: #F5F5F5; padding: 5px;" |
+* [[Limb]] [[ataxia]]
+* [[Gait abnormality|Gait disturbance]]
+* [[Dysarthria]]
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |−
 | style="background: #F5F5F5; padding: 5px;" |
+* Based on the time interval between [[stroke]] and [[imaging]] we may have different presentations
 | style="background: #F5F5F5; padding: 5px;" |
+* [[Imaging]]
 | style="background: #F5F5F5; padding: 5px;" |
+* [[Posterior inferior cerebellar artery]] is the most common artery that causes [[vertigo]]
 |-
 | style="background: #DCDCDC; padding: 5px; text-align: center;" |Brain stem ischemia
-| style="background: #F5F5F5; padding: 5px;" | +
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |−
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |−
-| style="background: #F5F5F5; padding: 5px;" |
 | style="background: #F5F5F5; padding: 5px;" |
+* Contralateral body [[Muscle weakness|weakness]]
+* [[Visual field]] deficits
+* [[Oculomotor nerve|Oculomotor]] abnormalities
+* [[Bulbar]] findings
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |−
 | style="background: #F5F5F5; padding: 5px;" |
+* Based on the time interval between [[stroke]] and [[imaging]] we may have different presentations
+* For more information [[Ischemic stroke CT|click here]]
 | style="background: #F5F5F5; padding: 5px;" |
+* [[Imaging]]
 | style="background: #F5F5F5; padding: 5px;" |
+* It may be associated with [[subclavian steal syndrome]]
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |Chiari malformation
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Chiari malformation]]<br><ref name="pmid15034729">{{cite journal |vauthors=Caldarelli M, Di Rocco C |title=Diagnosis of Chiari I malformation and related syringomyelia: radiological and neurophysiological studies |journal=Childs Nerv Syst |volume=20 |issue=5 |pages=332–5 |date=May 2004 |pmid=15034729 |doi=10.1007/s00381-003-0880-4 |url=}}</ref><ref name="pmid18809020">{{cite journal |vauthors=Sarnat HB |title=Disorders of segmentation of the neural tube: Chiari malformations |journal=Handb Clin Neurol |volume=87 |issue= |pages=89–103 |date=2008 |pmid=18809020 |doi=10.1016/S0072-9752(07)87006-0 |url=}}</ref>
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+| style="background: #F5F5F5; padding: 5px; text-align: center;" |−
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+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
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+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
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+| style="background: #F5F5F5; padding: 5px; text-align: center;" |−
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+* [[Tachycardia]]
+* [[Pupillary dilatation]]
+* Impaired [[gag reflex]]
+* Impaired [[coordination]]
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |−
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+* In [[CT scan]] we may see [[hydrocephalus]], herniated [[cerebellar tonsils]], and a flattened [[spinal cord]]
+* In [[MRI]] we may see [[Cerebellar tonsil|cerebellar tonsillar]] [[herniation]], wedge shaped tonsils, syringohydromyelia, small [[posterior fossa]], obstructive [[hydrocephalus]], and [[brainstem]] anomalies
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+* [[Imaging]]
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+* Patient may experience ringing in the [[Ear|ears]]
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |Parkinson
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Parkinson's disease|Parkinson]]<br><ref name="van Wensenvan Leeuwen2013">{{cite journal|last1=van Wensen|first1=E.|last2=van Leeuwen|first2=R.B.|last3=van der Zaag-Loonen|first3=H.J.|last4=Masius-Olthof|first4=S.|last5=Bloem|first5=B.R.|title=Benign paroxysmal positional vertigo in Parkinson's disease|journal=Parkinsonism & Related Disorders|volume=19|issue=12|year=2013|pages=1110–1112|issn=13538020|doi=10.1016/j.parkreldis.2013.07.024}}</ref><ref name="pmid3990948">{{cite journal |vauthors=Steiner I, Gomori JM, Melamed E |title=Features of brain atrophy in Parkinson's disease. A CT scan study |journal=Neuroradiology |volume=27 |issue=2 |pages=158–60 |date=1985 |pmid=3990948 |doi= |url=}}</ref><ref name="pmid15981079">{{cite journal |vauthors=Kosta P, Argyropoulou MI, Markoula S, Konitsiotis S |title=MRI evaluation of the basal ganglia size and iron content in patients with Parkinson's disease |journal=J. Neurol. |volume=253 |issue=1 |pages=26–32 |date=January 2006 |pmid=15981079 |doi=10.1007/s00415-005-0914-9 |url=}}</ref>
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+| style="background: #F5F5F5; padding: 5px; text-align: center;" |−
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+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
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+| style="background: #F5F5F5; padding: 5px; text-align: center;" |−
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+| style="background: #F5F5F5; padding: 5px; text-align: center;" |−
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+* [[Hypomimia]]
+* Cogwheel rigidity
+* Resting [[tremor]]
+* [[Gait Abnormalities|Gait problems]]
+* [[Bradykinesia]]
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |−
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+* On [[brain]] [[CT scan]], [[Parkinson's disease|Parkinson disease]] is characterized by cortical and subcortical [[atrophy]]
+* [[MRI]] findings in [[Parkinson disease]] are reduction in T2 relaxation time and reduced [[iron]] content in [[putamen]] and [[Globus pallidus|GPe]]
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+* [[History and Physical examination|History and physical examination]]
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+* Patients may present with slowness of movement ([[bradykinesia]]), shaking hands while they are at rest (resting [[tremor]]) and [[Muscle rigidity|muscle stiffness (rigidity)]].
 |}
+'''ABBREVIATIONS'''
+[[VZV]]= [[Varicella zoster virus]], [[MRI]]= [[Magnetic resonance imaging]], [[ESR]]= [[Erythrocyte sedimentation rate]], [[EEG]]= [[Electroencephalogram]], [[CSF]]= [[Cerebrospinal fluid]], GPe= [[Globus pallidus|Globus pallidus externa]], ICHD=  International Classification of Headache Disorders
 ==References==

Benign paroxysmal positional vertigo differential diagnosis: Difference between revisions

Latest revision as of 14:05, 29 October 2019

Overview

Differentiating BPPV from other Diseases

Differentiating BPPV from other diseases on the basis of vertigo, nystagmus, and hearing problems

References

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