Benign paroxysmal positional vertigo Flashcards
What is Benign paroxysmal positional vertigo?
Benign Paroxysmal Positional Vertigo is a condition characterised by paroxysmal attacks of vertigo following head movement.
It occurs secondary to otolith detachment in the inner ear which leads to hair cell stimulation and subsequent symptoms of vertigo.
What are features of Benign paroxysmal positional vertigo?
vertigo triggered by change in head position (e.g. rolling over in bed or gazing upwards)
may be associated with nausea
each episode typically lasts 10-20 seconds
positive Dix-Hallpike manoeuvre,
There are no auditory symptoms for BPPV.
What is the prognosis of Benign paroxysmal positional vertigo?
good prognosis usually resolves spontaneously after a few weeks to months
What is the treatment for Benign paroxysmal positional vertigo?
usually resolves spontaneously after a few weeks to months but Symptomatic relief may be gained by:
Epley manoeuvre (successful in around 80% of cases)
teaching the patient exercises they can do themselves at home, termed vestibular rehabilitation, for example Brandt-Daroff exercises
Medication is often prescribed (e.g. Betahistine) but it tends to be of limited value.
Around half of people with BPPV will have a recurrence of symptoms 3–5 years after their diagnosis
What is the most common cause of vertigo?
Benign paroxysmal positional vertigo
Where is Benign paroxysmal positional vertigo predominately seen? Why?
elderly population due to deposition of calcium deposits (cholelithiasis) within the semicircular canals.
What is the diagnostic test for Benign paroxysmal positional vertigo?
Dix-Hallpike manoeuvre
What is Dix-Hallpike manoeuvre?
patient experiences vertigo
rotatory nystagmus
What is Epley manoeuvre?
The Epley maneuver is designed to put the head at an angle from where gravity can help relieve symptoms. Tilting the head can move the crystals out of the semicircular canals of the ear. This means that they stop displacing fluid, relieving the dizziness and nausea this was causing
What is most commonly affected in benign paroxymal posterior vertigo?
The posterior canal
What are causes of benign paroxymal posterior vertigo?
Most cases of BPPV are idiopathic.
Other known causes of BPPV include:
Head injury
Vestibular neuronitis (post-viral illness)
Labyrinthitis (due to age-related degeneration of the labyrinth)5
Complications of mastoid/stapes surgery
What are risk factors of benign paroxymal posterior vertigo?
Older age (onset common between 40 to 60 years old).
Female sex (women are twice as likely to have BPPV compared to men)
Meniere’s disease (usually diagnosed alongside BPPV in 30% of cases)
Patients with migraines and/or anxiety disorders2
