Diagnosis and surgical treatment of disabling positional vertigo.

This report reviews the characteristic symptoms of disabling positional vertigo (DPV), and the tests used to reach a differential diagnosis of this disorder. Twenty-one patients were operated on consecutively for management of DPV between March, 1983, and September, 1984. In all patients one or more arteries or veins was found to be compressing the eighth cranial nerve when the nerve was exposed for microvascular decompression to relieve the symptoms of DPV. After the operation, 16 of the 21 patients were free of symptoms, or symptoms were so much improved that the patients returned to normal work or social life. Two patients had no improvement and three had limited relief of symptoms postoperatively. None of the patients experienced hearing loss as a result of the operation to relieve DPV, but one patient suffered a cerebellar contusion during the operation.