Publication:

Chiari type 1 malformation presenting as an atypical benign paroxysmal positional vertigo in a 16 year old patient

Dizziness and vertigo are very common symptoms and can be difficult to distinguish clinically. Vertigo is a specific subtype of dizziness in which a patient experiences the illusion of motion (often rotatory) of either themselves or their surroundings. Vertigo can be either peripheral (arising within the labyrinth) or central (brain). It is important to identify central aetiologies as they can be fatal if missed. This case report narrates a 16-year-old male who presented complaining of vertigo related to changes in head position which was initially misdiagnosed as a benign paroxysmal positional vertigo (BPPV). It was several years before he was correctly diagnosed as having Chiari type 1 malformation on MRI scan. He underwent a surgical decompression with complete alleviation of his symptoms. All cases of atypical vertigo should be evaluated in detail. Patients with failure of initial management should undergo imaging to identify any central pathology.