Practical Aspects in Central Paroxysmal Positional Vertigo

Human vertiginous pathology is dominated by benign positional paroxysmal vertigo (BPPV) in about 39% of cases. Sometimes the practitioner is faced with similar, but centrally located forms - central positional paroxysmal vertigo (CPPV), generating difficult of clinical interpretations. Aim This article presents practical aspects of the physician's attitude towards this type of pathology. The prognosis of these conditions could be severe, because CPPV may be the inaugural sign of posterior stroke - with a cardiovascular origin, or is the testimony of another serious brain pathology - degenerative, tumors. Review Methods and Data sources Review of the available literature (Medpub, Cochraine Library, medical specific literature). Results and Conclusion Positional testing for BPPV diagnosis (Dix Hallpike, Roll, Bow and Lean etc.) resulting in "atypical form of BPPV" or pure vertical/torsional nystagmus may indicate a central vestibular disorder.