BENIGN PAROXYSMAL POSITIONAL VERTIGO

Benign paroxysmal positional vertigo (BPPV) has received renewed clini cal interest. At the Johns Hopkins Otological Vestibular Laboratory, 7 81 patients were tested on more than one occasion between September 19 76 and November 1992. Of these patients, 187 (24%) were found to have positional nystagmus consistent with a diagnosis of BPPV. A retrospect ive analysis of these patients' records, including vestibular test and eye movement reports, audiograms, questionnaires, and hospital charts was performed, After this review, the nystagmus, initially diagnosed as due to BPPV, was believed to be a manifestation of another disease process in 36 cases. Of the remaining 151 cases, 52 (34%) presented wi th no significant preceding disorder and have been termed primary BPPV In the remaining 99 patients we found coexisting or associated disord ers which included Meniere's disease, head trauma, prior ear surgery, vestibular neuronitis, migraine, and others. Forty-five of these 151 p atients (31%) had an associated diagnosis of Meniere's disease. To our knowledge a significant association between Meniere's disease and BPP V has not been reported, A review of the literature with discussion of BPPV and the associated disorders is offered.