Positional Convergence Spasm: A Case Report

Abstract

Benign paroxysmal positional vertigo is one of the most common causes of vertigo. Although quite bothersome, this condition can be easily treated using simple maneuvers. Sudden-onset diplopia, on the other hand, may indicate serious medical conditions. On rare occasions, diplopia may be related to psychogenic convergence spasm and can be induced by positional maneuvers. We report the case of a patient presenting positional vertigo and brief episodes of diplopia without nystagmus, in whom psychogenic convergence spasm was provoked during positional testing. This rare phenomenon highlights the importance of considering functional etiologies in the differential diagnosis of atypical vertigo presentations to avoid unnecessary investigations.

Keywords: benign paroxysmal positional vertigo (bppv); positional convergence spasm; psychogenic convergence spasm; spasm of the near reflex; vertigo diagnosis.