BPPV Flashcards
What is BPPV?
Benign paroxysmal positional vertigo - sudden onset of vertigo following head movements
How does BPPV present?
Sudden onset vertigo after head movements
Vertigo lasts 20-60 seconds
Patients are asymptomatic between attacks
How is BPPV differentiated from labyrnithitis?
BPPV does not cause hearing loss
What is the cause of BPPV?
Calcium carbonate crystals called octonia become lodged in the semi circular canals. The normal flow of endolymph through the canals is distrupted.
What causes the crystals to become displaced?
Viral infection
Head trauma
Aging
Idiopathic
Where are the crystals most commonly displaced?
Posterior semicircular canal
How is BPPV diagnosed?
Dix-hallpike manoeuvre
How is the dix-hallpike manoeuvre performed?
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
What is the first line management of BPPV?
Epley manoeuvre
What else can be done to improve BPPV?
Brandt-Daroff exercises
What is involved in Brandt-Daroff exercises?
Involves sitting on the edge of a bed and lying sideways, from one side to the other
What is Meniere’s disease?
Recurrent episodes of vertigo, nausea, hearing loss, tinnitus and aural fullness
How does Meniere’s disease differ from acute labyrinthitis?
Symptoms are similar, but Meniere’s disease is recurrent whereas acute labyrinthitis occurs as one episode
What medication can be used for prophylaxis of menieres disease?
Betahistine
What medication an be used to treat acute attacks of menieres’s disease?
Prochlorperazine
Antihistamines
