Benign paroxysmal vertigo was previously described under the childhood periodic syndromes spectrum, which also included cyclical vomiting, abdominal migraine, and benign periodic torticollis. The most updated version of the International Classification of Headache Disorders (ICHD-3 beta version) has replaced the term ‘‘periodic symptoms’’ with ‘‘episodic symptoms which are associated with migraine’’ (1.6), and the term is no longer limited to the childhood population.
This disorder consists of recurrent attacks (at least 5) of severe sudden vertigo that resolve spontaneously. At least 1 of the following including nystagmus, ataxia, vomiting, pallor, and/or fearfulness should be present, and consciousness is maintained through the event. Neurologic examination and vestibular and audiometric functions are all normal between attacks, as are imaging studies and electroencephalography. The attacks may last minutes to hours and in extreme cases as long as 2 days. In this article, the author explains the clinical manifestations, why caution must be exercised to exclude the differential diagnoses, the appropriate recommended workup, and important treatment options.