Benign Paroxysmal Positional Vertigo

Question 1

def

Answer 1

vertigo which lasts seconds to minutes on changing head position (sitting to lying down, turning head suddenly)

Question 2

aetiology

Answer 2

1 primary (idiopathic) which is most common
2 secondary to trauma, labyrinthitis, migraines

these cause migration of free-floating otolith particles into the posterior (most common), horizontal (less common) or anterior (rare) semicircular canals which renders them sensitive to gravity

Question 3

epi

Answer 3

common in middle-age

one of the most common causes of vertigo

Question 4

risk factors

Answer 4

increasing age
female
trauma, labyrinthitis, migraines

Question 5

history + examination

Answer 5

vertigo is provoked by specific head movements
vertigo is sudden onset, episodic and brief
associated symptoms such as nausea, imbalance, faintness may be present
O/E normal neurological examination

Question 6

investigations

Answer 6

history, examination, and positive Dix-Hallpike manoeuvre is sufficient for diagnosis of BPPV

Question 7

what is vertigo

Answer 7

sensation that the environment is spinning around relative to oneself or vice versa

Question 8

what is the Dix-Hallpike manoeuvre

Answer 8

a manoeuvre used to diagnose posterior canal BPPV (and anterior canal BPPV but this is very rare

the examiner positions the patient so that the posterior canal is vertically oreintated and the head moves in the plane of the canal
as a result otolith particles gravitate downwards precipitating an episode of BPPV