Benign paroxysmal positioning vertigo with indeterminate cerebellar lesion: case report.

Of the numerous causes of dizziness, those that represent a life-threatening condition are rare. Physicians must guard against missing these rare but serious conditions while controlling the cost of the evaluation of patients who present with dizziness. This case study involving a 41-year-old female was written to illustrate the importance of systematic case history taking and of obtaining an ENG. The patient presented with classic symptoms of benign paroxysmal positioning vertigo (BPPV). The managing physician performed an MRI, which showed a cerebellar lesion. Results of a biopsy were negative. The patient's symptoms persisted, and she travelled to our clinic for further assessment. An ENG demonstrated a classic response to the Dix-Hallpike maneuvers, and a canalith repositioning maneuver was performed. The positioning dizziness resolved, and when contacted several months later, the patient stated she had remained asymptomatic.