BPPV Flashcards
BPPV
benign paroxysmal positional vertigo
AC
anterior semicircular canal, also sometimes called superior canal
DBN
down-beating nystagmus
LC
lateral or also called horizontal semicircular canal
PC
posterior semicircular canal, also sometimes called inferior canal
UBN
up-beating nystagmus
BPPV symptoms:
Tilting of head
Looking up or down (top-shelf vertigo)
Rolling over in bed
Nausea & vomiting
Canalithiasis
Debris floating freely in the endolymph in the long arm of the semi circular canal ( SCC)
Cupulolithiasis
Debris, probably fragments of otoconia from the utricle, adhere to the cupula
Positive for Posterior Canal BPPV is
Upbeating
Ispilateral Torsional
+ Latency
Patient with c/o vertigo during nystagmus
Positive for Anterior Canal BPPV is
Downbeathing
Ispilateral Torsional
+ Latency
Patient with c/o vertigo during nystagmus
Return to play rehab stage 1 objective:
recovery
Return to play rehab stage 2 objective:
Increase HR
Return to play rehab stage 3 objective:
Add movement
Return to play rehab stage 4 objective::
exercise, coordination and cognition level
Return to play rehab stage 5 objective:
restore confidence and assess functional skills by coaching staff
Return to play rehab stage 1 exercise
symptom limited and cognitive test
Return to play rehab stage 2 exercise
walking, swimming, cycling, keeping intensity less than 70% permitted HR, no resistance
Return to play rehab stage 3 exercise
skating drills in ice hockey, running drills in soccer. no head impact activities
Return to play rehab stage 4 exercise
progression to more complex training drills, passing in football, start resistance training
Return to play rehab stage 5 exercise
follow medical clearance participate in normal training activities
Return to play rehab stage 6 exercise
normal game play
Rehab stage 1
no activity
Rehab stage 2
light aerobic exercise
Rehab stage 3
sport specific exercise
Rehab stage 4
non contact training drills
Rehab stage 5
full contact practice
Rehab stage 6
return to play
Tropia
overt deviation of the eye
Phoria
ocular deviation occurs when disassociation occurs
What areas are responsible for binocular vision?
accomadative system oculomotor system vergence system ocular alingment VOR system
Manifestation of labyrinthine concussion:
ataxia, imbalance, BPPV,
Manifestation of skull fracture concussion:
UVL or BVL (partial or complete)
Conductive hearing loss
Mixed peripheral or central symptoms
Manifestation of hemorrhage into labyrinth
post traumatic hydrops (similar to Menieres)
acute vertigo
unilateral hearing loss
Manifestation of hemorrhage into brainstem
oculomotor signs, poor smooth pursuits, vertigo, perception of tilt
Manifestation of increased intracranial pressure:
fluctuating hearing loss, ataxia, imbalance
Right roll with Canalithiasis
right beating geotrophic nystagmus with short duration
Left roll with Canalithiasis
left beating geotrophic nystagmus with short duration
Side involved with horizontal canalithiasis:
More sysmtpms/ stronger nystagmus
Right roll with Cupulolithiasis:
left beating ageotrophic nystagmus with long duration
Left roll with Cupulolithiasis:
right beating ageotrophic nystagmus with long duration
Side involved with horizontal Cupulolithiasis:
side that causes fewer symptoms/ nystagmus
Posterior canal affected:
upbeating and torsional (toward affected ear)
Horizontal canalithiasis:
geotrophic (right beating in head right position; left beating in left head position
Horizontal Cupulolithiasis:
ageotrophic (left beating in right head position, right beating in left head position
Anterior canal affected:
down-beating and torsional (toward affected ear)
