Exams and Tests

Benign paroxysmal positional vertigo (BPPV) is diagnosed with a physical exam and your medical history. But diagnosing the cause of the spinning, whirling sensation of vertigo can be difficult. Several diseases, the side effects of medicines, and head injuries can also cause vertigo.

A Dix-Hallpike test may be done to help your doctor find out the cause of your vertigo. During this test, he or she will carefully observe any involuntary eye movements. This will help your doctor know whether the cause of your vertigo is inside your brain, your inner ear, or the nerve connected to your inner ear. The Dix-Hallpike test also can help your doctor find out which ear is affected.

If your symptoms or the results of your exam make your doctor think you don't have BPPV, other tests may be done:

• Electronystagmography, which attaches small wires to your face that measure eye movements. It looks for the special eye movements that happen when the inner ear is stimulated. The pattern of eye movements can point to the location of the cause of the vertigo, such as the inner ear or the central nervous system.
• Imaging tests, such as magnetic resonance imaging of the head (MRI) or computed tomography of the head (CT scan). These tests may be done if the symptoms and exam findings could be caused by a brain problem.
• Hearing testing to detect hearing loss. A special hearing test can determine whether the nerve from the inner ear to the brain is working correctly. Hearing loss with vertigo usually points to a problem other than BPPV, such as Ménière's disease or labyrinthitis.