Brief vertigo triggered by lying down, rolling over in bed or looking up is most often posterior canal benign paroxysmal positional vertigo. A Dix–Hallpike test showing torsional upbeating nystagmus after a short latency, fading within a minute, confirms it.
An Epley manoeuvre done in the same consultation treats most patients, needs no equipment, and avoids weeks of vestibular sedatives, which delay central compensation.
- Ask whether vertigo is triggered by position change and lasts under a minute
- Perform Dix–Hallpike on both sides
- Treat a positive test with an Epley manoeuvre immediately
- Avoid prescribing betahistine or prochlorperazine for confirmed BPPV
- Refer if nystagmus is atypical, persistent or purely vertical downbeating
Why it matters
BPPV is often treated with weeks of sedatives when a two-minute manoeuvre resolves it.
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