Vertigo on movement sideways (449/1700)

A young pt is complaining of vertigo whenever she moves sideways on the bed while lying
supine. What would be the most appropriate next step?
a. Head roll test
b. Reassure
c. Advice on posture
d. Carotid Doppler
e. CT


























Answer: A, presenting with BPPV, do a manaveur to localize the otolith and confirm diagnosis.
Tests like the Dix-Hallpike or Roll Tests involve moving the head into specific orientations, which allow gravity to move the dislodged crystals and trigger the vertigo while the practitioner watches for the tell-tale nystagmus. Once confirmed, Reassure +/- maneuvers to dislodge the otolith.