BPPV Flashcards
Debris (otoconia) from the UTRICLE is floating in the endolymph fluid in the semicircular canal; When head is moved toward the provoking position, the debris moves to the lowest portion of the canal; The movement of the debris causes endolymph movement, which deflects the cupula and changes the firing rate of the hair cells in that canal
Canalithiasis
What is the most common form of BPPV?
Canalithiasis
- latency (5-60s) nystagmus
- takes 25s for an otoconia to traverse ¼ of the canal
BPPV with no latency of nystagmus; immediate onset of vertigo when moved into provoking position; longer nystagmus (60s+)
Cupulolithiasis
involuntary oscillation of the eyes; Typically consists of a fast and a slow component
nystagmus
- The direction of the FAST component defines the direction of the nystagmus
- Normal: Rotational , Caloric-induced, Optokinetic and at end range of gaze (gaze holding nystagmus)
- Pathological: Spontaneous, Positional, Gaze-evoked
What direction of nystagmus is present with an anterior or posterior SCC?
upsetting/ downbeating with torsional component
What direction of nystagmus is present with horizontal SCC?
geotropic/ageotrpoic
- toward earth = GEO
- away from earth = AGEO
What BPPV is present?
Upbeating right torsion(counterclockwise from the therapist perspective)
Right posterior canal
What BPPV is present?
Down beating right torsion (counterclockwise from the therapist perspective)
Right Anterior canal
What BPPV is present?
Upbeating, left torsion (clockwise)
Left Posterior canal
What BPPV is present?
Down beating left torsion (clockwise)
Left Anterior canal
horizontal nystagmus; geotropic (toward the earth)
Canalitiasis
- named R or L for side of head that’s down and when most symptomatic
Horizontal nystagmus; ageotropic or apogeotropic (away from the earth)
cupulothiasis
- named R or L for side of head that’s down and when most symptomatic
