Case 4 — Brief positional vertigo, normal vHIT

A 59-year-old woman reports 5 days of brief spinning vertigo whenever she rolls to the right in bed or looks up. Each spell lasts about 20 seconds. There is no constant unsteadiness, no hearing loss, no headache. Dix-Hallpike to the right produces brief up-beat torsional nystagmus with vertigo, settling spontaneously. The treating physiotherapist obtains a vHIT prior to repositioning.