title: Malignant paroxysmal positional vertigo.
abstract: OBJECTIVE
  An insidious percentage of paroxysmal positional vertigo appears to be intractable with canalith repositioning maneuver and also is not self-limiting. This type of positional vertigo is sustained by the action of intracranial tumors that mimics the clinical aspects of benign paroxysmal positional vertigo.Aim of this study is to clarify the features of these forms of positional vertigo, which we indicate as malignant paroxysmal positional vertigo.
  
  
  METHODS
  We retrospectively reviewed the clinical records of all the patients who presented with vertigo spells and were managed at our tertiary care referral centre over a three years period. Two hundred and eleven patients with diagnosis of positional paroxysmal vertigo were included in the final study.
  
  
  RESULTS
  Seven patients were affected by intracranial tumors causing a positional vertigo and were classified as malignant paroxysmal positional vertigo patients after radiological and histological diagnosis. These patients were affected by an internal auditory canal mass alone or with extension in the cerebello pontine angle that mimicked a benign positional vertigo.
  
  
  CONCLUSIONS
  We can conclude that the clinician should keep in mind the differentiation between benign positional vertigo and malignant positional vertigo. When the patients with positional vertigo presents a strange behaviour of symptoms, nystagmus or response to the canalith repositioning maneuver a radiological investigation must be undertaken in every doubtful case.
authors: ENT Institute, Department of Surgical, Clinical and Experimental Sciences, G.d'Annunzio University of Chieti and Pescara, Italy. dr.adestefano@gmail.com
authors: Alessandro
authors: A
authors: De Stefano
authors: Gautham
authors: G
authors: Kulamarva
authors: Francesco
authors: F
authors: Dispenza
mesh_terms: D065635:Benign Paroxysmal Positional Vertigo; D001932:Brain Neoplasms / Q000150:complications* / Q000175:diagnosis*; D003937:Diagnosis, Differential; D006801:Humans; D008577:Meningeal Neoplasms / Q000150:complications / Q000175:diagnosis; D008579:Meningioma / Q000150:complications / Q000175:diagnosis; D009464:Neuroma, Acoustic / Q000150:complications / Q000175:diagnosis; D012189:Retrospective Studies; D014717:Vertigo / Q000175:diagnosis* / Q000209:etiology*