BPPV

Question 1

What is BPPV?

Answer 1

Benign paroxysmal positional vertigo - sudden onset of vertigo following head movements

Question 2

How does BPPV present?

Answer 2

Sudden onset vertigo after head movements
Vertigo lasts 20-60 seconds
Patients are asymptomatic between attacks

Question 3

How is BPPV differentiated from labyrnithitis?

Answer 3

BPPV does not cause hearing loss

Question 4

What is the cause of BPPV?

Answer 4

Calcium carbonate crystals called octonia become lodged in the semi circular canals. The normal flow of endolymph through the canals is distrupted.

Question 5

What causes the crystals to become displaced?

Answer 5

Viral infection
Head trauma
Aging
Idiopathic

Question 6

Where are the crystals most commonly displaced?

Answer 6

Posterior semicircular canal

Question 7

How is BPPV diagnosed?

Answer 7

Dix-hallpike manoeuvre

Question 8

How is the dix-hallpike manoeuvre performed?

Answer 8

Start with the patient sitting upright on a couch
Turn the patient’s head to 45 degrees
Quickly lower the patient backwards, with their head hanging off the back of the bed
Look for nystagmus
Repeat on the other side

Question 9

What is the first line management of BPPV?

Answer 9

Epley manoeuvre

Question 10

What else can be done to improve BPPV?

Answer 10

Brandt-Daroff exercises

Question 11

What is involved in Brandt-Daroff exercises?

Answer 11

Involves sitting on the edge of a bed and lying sideways, from one side to the other