Benign Paroxysmal Positional Vertigo Workup

Updated: Jan 14, 2022
  • Author: John C Li, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
  • Print

Laboratory Studies

Because the Dix-Hallpike maneuver is pathognomonic, laboratory tests are not needed to make the diagnosis of benign paroxysmal positional vertigo (BPPV). However, since a high association with inner ear disease exists, laboratory workup may be needed to delineate these other pathologies.


Imaging Studies

Imaging studies are not needed in the workup of a patient in whom BPPV is suspected.


Other Tests

See the list below:

  • The Dix-Hallpike maneuver is the standard clinical test for BPPV (see Physical).

  • Electronystagmography

    • Torsional eye movement cannot be demonstrated directly, but occasionally electronystagmography (ENG) is helpful in detecting the presence and timing of nystagmus.

    • Caloric test results can be normal or hypofunctional.

    • According to Mohammed Hamid, MD, a reduced vestibular response can occur secondary to the sluggishness of the particle-laden endolymph.

    • BPPV can originate in an ear with an absent caloric response because the nervous and vascular supply to the horizontal canal is separate from that of the PSCs.

  • Infrared nystagmography: Torsional eye movement can be demonstrated directly.

  • Audiogram: The result of an audiogram may be normal.

  • Posturography: Posturography results are often abnormal but follow no predictable or diagnostic pattern.