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DPT 761 - Neuro Rehab II > A-Typical BPPV > Flashcards

A-Typical BPPV Flashcards

1
Q

What is Atypical BPPV?

A

Atypical BPPV involves the less commonly affected semicircular canals: anterior and horizontal canals.

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2
Q

What are the three semicircular canals involved in BPPV?

A

The posterior, anterior, and horizontal semicircular canals.

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3
Q

Which semicircular canal is most commonly affected in BPPV?

A

The posterior semicircular canal.

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4
Q

Which tests are recommended for diagnosing anterior canal BPPV?

A

Dix-Hallpike or Deep Head Hanging Test.

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5
Q

What type of nystagmus is seen in anterior canal BPPV during the Dix-Hallpike test?

A

Downbeating and torsional nystagmus.

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6
Q

What are the common treatment maneuvers for anterior canal BPPV?

A

Epley, Reverse Semont, and other possible maneuvers (though not covered in this course).

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7
Q

Which semicircular canal is the second most common site for BPPV?

A

The horizontal semicircular canal.

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8
Q

What type of nystagmus is associated with horizontal canal BPPV?

A

Horizontal nystagmus.

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9
Q

What symptoms are typical of horizontal canal BPPV?

A

Symptoms are similar to posterior canal BPPV but may not be described as ‘spinning.’ Symptoms may occur with rolling in bed or turning the head to both sides.

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10
Q

What is the recommended test if Dix-Hallpike is negative but BPPV is still suspected?

A

The Supine Roll Test.

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11
Q

How is the Supine Roll Test performed?

A

The patient’s head is turned 90° to each side while lying supine with 20° cervical flexion, holding each position for 30-60 seconds to check for nystagmus and vertigo.

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12
Q

What indicates a positive result for horizontal canal BPPV in the Supine Roll Test?

A

Vertigo and nystagmus are present when the head is turned to both sides, with stronger responses on one side.

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13
Q

What are the two conditions that need to be differentiated in horizontal canal BPPV?

A

Canalithiasis and cupulolithiasis.

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14
Q

What type of nystagmus is indicative of canalithiasis in horizontal canal BPPV?

A

Geotropic nystagmus (beating toward the ground).

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15
Q

What is the typical duration of nystagmus in geotropic horizontal canal BPPV?

A

Less than 1 minute.

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16
Q

What type of nystagmus is indicative of cupulolithiasis in horizontal canal BPPV?

A

Apogeotropic nystagmus (beating away from the ground).

17
Q

What is the typical duration of nystagmus in apogeotropic horizontal canal BPPV?

A

More than 1 minute.

18
Q

How can the affected ear be determined in horizontal canal BPPV?

A

In geotropic nystagmus (canalithiasis), the stronger nystagmus indicates the affected ear. In apogeotropic nystagmus (cupulolithiasis), the weaker nystagmus indicates the affected ear.

19
Q

What is the BBQ maneuver?

A

A 270° roll in the plane of the horizontal canal, ending in the prone position.

20
Q

For which type of horizontal canal BPPV is the BBQ maneuver most effective?

A

Geotropic (canalithiasis) but can be used for both forms.

21
Q

What should be considered if BPPV does not improve after 3-5 visits?

A

Consider referring to a specialist or further investigating the cause.

22
Q

What patient education is recommended following a BPPV treatment session?

A

Advise the patient to take it easy the day of treatment and avoid excessive bending or lying flat. Return to normal activities afterward with free head movements.

23
Q

What is the characteristic nystagmus direction in geotropic horizontal canal BPPV?

A

Nystagmus beats toward the ground.

24
Q

What is the characteristic nystagmus direction in apogeotropic horizontal canal BPPV?

A

Nystagmus beats away from the ground.

25
Q

How does the intensity of nystagmus help in identifying the affected ear in canalithiasis?

A

Stronger nystagmus and vertigo on the affected side.

26
Q

How does the intensity of nystagmus help in identifying the affected ear in cupulolithiasis?

A

Weaker nystagmus and vertigo on the affected side.

27
Q

Why is it often difficult to determine the affected ear in horizontal canal BPPV?

A

Because nystagmus and vertigo are present when turning to both sides.

28
Q

What does the term ‘geotropic’ mean in the context of BPPV?

A

Geotropic means ‘toward the earth,’ indicating nystagmus beating toward the ground.

29
Q

What does the term ‘apogeotropic’ mean in the context of BPPV?

A

Apogeotropic means ‘away from the earth,’ indicating nystagmus beating away from the ground.

DPT 761 - Neuro Rehab II (16 decks)

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