Benign paroxysmal vertigo, bilateral
ICD-10 H81.13 is a billable code used to indicate a diagnosis of benign paroxysmal vertigo, bilateral.
Benign paroxysmal vertigo (BPV) is a vestibular disorder characterized by brief episodes of vertigo triggered by changes in head position. When classified as bilateral, it indicates that the condition affects both ears, leading to a more complex clinical presentation. Patients may experience sudden, intense spinning sensations, often accompanied by nausea and balance disturbances. The episodes are typically brief, lasting seconds to minutes, and can be provoked by specific movements such as rolling over in bed or looking up. The underlying mechanism involves dislodged otoliths (calcium carbonate crystals) that migrate into the semicircular canals of the inner ear, disrupting normal fluid movement and signaling to the brain. Diagnosis is primarily clinical, supported by a thorough history and physical examination, including the Dix-Hallpike maneuver. Management often includes vestibular rehabilitation therapy and, in some cases, repositioning maneuvers to relocate the otoliths. While BPV is generally self-limiting, bilateral cases may require more extensive evaluation to rule out other vestibular disorders or central causes.
Detailed history of vertigo episodes, triggers, and physical examination findings.
Patients presenting with recurrent vertigo episodes, particularly after head movements.
Ensure clear documentation of bilateral symptoms and any differential diagnoses considered.
Comprehensive neurological examination and assessment of vestibular function.
Patients with vertigo and additional neurological symptoms, requiring differentiation from central causes.
Document any neurological findings that may suggest a central vestibular disorder.
Used to assess vestibular function in patients with vertigo.
Document the rationale for testing and findings.
Otolaryngologists should ensure that the test results are clearly linked to the diagnosis.
Common triggers include specific head movements such as tilting the head back, rolling over in bed, or looking up. These movements can cause the dislodged otoliths to stimulate the vestibular system, leading to vertigo.
