recurrent spontaneous vertigo; benign recurrent vertigo; recurrent vestibular vertigo

Classification

• presumably peripheral vertigo because of benign nature

Etiology

• idiopathic
• regarded in past as a variant of Meniere's disease or vestibular migraine
  • may include benign paroxysmal positional vertigo

Clinical manifestations

• vertigo
• interictal prolonged headshaking nystagmus
  • headshaking for 15-20 seconds may induce nystagmus
  • after headshaking, the nystagmus peaks quickly, then slowly subsides (primary phase)
  • a weaker nystagmus may then develop, slowly building before slowly decreasing
• marked susceptibility to motion sickness

Management

• nimodipine, betahistine, propranolol, flunarizine, baclofen, nortriptyline, & acetazolamide used in various combinations

More general terms

• peripheral vertigo