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Key Clinical Message  Different balance problems may occur in the same patient simultaneously, and the other problem may be overlooked if the clinician does not pay much attention. Spontaneous nystagmus of Meniere's disease and positional nystagmus of posterior canal  BPPV  in the same patient is presented. Positional tests must always be considered even in the presence of spontaneous nystagmus.

Should the clinician do the tests for benign paroxysmal positional vertigo even in the presence of spontaneous nystagmus at primary gaze?