Summary
Background. Benign paroxysmal positional vertigo (BPPV) is the most common subtype of vertigo, that results in self-resolving and paroxysmal episodes of nausea, vomiting, and dizziness. Middle-aged women are most frequently affected. Vestibular neuritis is a viral inner ear disorder characterized by acute vertigo accompanied by nausea and vomiting. It is the second most common cause of secondary BPPV.
Case report. A 21-year-old male patient presented to the emergency room after experiencing severe vertigo after waking up in the morning, accompanied by a walking imbalance. He was diagnosed with vestibular neuritis and after a few months, a Dix-Hallpike and a supine roll test yielded positive results, with right peripheral nystagmus being present during both. The diagnosis of secondary posterior and horizontal benign paroxysmal positional vertigo was determined. The patient was treated with various repositional maneuvers, which proved to be advantageous for a short period of time, soon after the symptoms got worse. The patient started to face problems with focusing the eyes and temporary vertigo attacks with a slight left nystagmus with a rotary component. As a result of recurring BPPV, therapy was provided. Moreover, vestibular rehabilitation as well as modified repositional maneuvers were consistently done for 12 months. As a result of the treatment, the symptoms have improved, with the complaints not disappearing entirely.
Conclusion. Vestibular neuritis can cause a secondary BPPV, with it usually being treatment-resistant. We suggest a thorough examination of patients with VN due to the possibility of BPPV.
