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Benign paroxysmal positional vertigo — DGM MCQ

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ModerateFallsBenign paroxysmal positional vertigoDGM

An 85-year-old woman falls when turning her head to answer the door. She describes seconds of spinning vertigo when rolling over in bed. Neurological examination is normal and Dix-Hallpike testing reproduces vertigo with torsional nystagmus. What is the most likely diagnosis?

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Correct answer: B — Benign paroxysmal positional vertigo

Brief positional vertigo with torsional nystagmus on Dix-Hallpike testing is typical of BPPV. Vertebrobasilar TIA is more concerning when symptoms are non-positional or accompanied by focal neurological features. BPPV is a treatable contributor to falls and should not be dismissed as ageing.

Reference: NICE NG127