Paroxysmal positional vertigo in the elderly.

In a retrospective study of 806 patients 70 years of age or older complaining of dizziness, 328/806 (40.7%) patients gave a history strongly suggestive of paroxysmal positional vertigo. This prevalence was higher than in other age groups of 7,269 patients seen in our Dizziness Clinic (33.7% in patients 50 years of age or younger; 26.6% in patients 40 years of age or younger). In 158/328 patients, the paroxysm was elicited and nystagmus occurred; in 135/158 patients, the observed nystagmus, during the paroxysm, was identified and in 131/135 patients, it was of the type described by Barany. It is concluded that: (a) the prevalence of paroxysmal positional vertigo increases with advancing age; (b) the usually observed nystagmus, during the paroxysm, in the elderly is of the type described by Barany, and similar to the nystagmus observed in other age groups.