Benign Paroxysmal Positional Vertigo (BPPV)

Question 1

What is BPPV

Answer 1

Vertigo triggered by head movements

Question 2

Presentation of BPPV

Answer 2

50-70yr old female
Brief recurrent attacks of vertigo that last seconds to minutes
Aggravated by changes in head positions

Question 3

Causes of BPPV

Answer 3

Crystals of calcium carbonate (otoconia) become displaced in the semicircular canals (most commonly post. semicircular canal).
May be displaced by head trauma, viral infection, ageing
Crystals disrupt normal flow of endolymph = vertigo

Question 4

Differentials of BPPV

Answer 4

Migraine, Labyrinthitis, Meniere’s disease, Vestibular neuronitis

Question 5

BPPV investigations

Answer 5

Dix-Hallpike manoeuvre - triggers vertigo in BPPV

Question 6

BPPV management

Answer 6

Epley manoeuvre - moves crystals to position where they don’t disrupt endolymph flow
Anti-emetics e.g. Prochlorperazine