Benign paroxysmal positional vertigo after radiologic scanning: a case series

The first patient with headache and tremor was admitted to the radiology department for cranial computed tomography (CT) imaging. During scanning, she was asked to lie in the supine position with no other head movements for approximately 10 minutes. After the cranial CT imaging, she stood up rapidly, and suddenly experienced a vertigo attack and nausea. The second patient was admitted to the radiology department for evaluation of his renal arteries. During the renal magnetic resonance angiography, he was in the supine position for 20 minutes and asked not to move. After the examination, he stood up rapidly with the help of the technician and suddenly experienced a vertigo attack with nausea and vomiting. The results of standard laboratory analyses and their neurologic examinations were within normal limits and Dix-Hallpike tests showed rotatory nystagmus in both cases. An Epley maneuver was performed to the patients. The results of a control Dix-Hallpike tests after 1 Epley maneuver were negative in both patients.Radiologists and clinicians must keep in mind that after radiologic imaging in which the patient is still for some time in the supine position and then helped to stand up rapidly, a BPPV attack may occur.Benign paroxysmal positional vertigo (BPPV) is the most common type of vertigo and is defined as a vestibular syndrome of peripheral origin characterized by short and intense episodes of vertigo, associated with predominantly horizontal-rotation nystagmus, triggered by a quick change of head position [1-4]. It is benign because it is not progressive; paroxysmal because it is sudden and unpredictable in onset; positional because it comes about because of a change in head position; and vertigo because of a sense of spinning of the room or whirling. It is more often seen in women than in men [5]. It occurs at all ages, but its occurrence increases with age. Long-term bed rest, extended travel, head trauma, and upper respiratory system infections are believed t