BPPV

Question 1

What is BPPV?

Answer 1

Benign paroxysmal positional vertigo

Peripheral vestibular disorder with short episodes of vertigo

Question 2

What is the pathophysiology of BPPV?

Answer 2

Canalith particles migrate into semicricular canals over time

The particles are denser tha the endolymph fluid

Certain head movements cause the particles to shift, disturbing the hair cells and causing vertigo

Question 3

What are risk factors for BPPV?

Answer 3

Increasing age
Female
Head trauma 
Vestibular neuronitis
Labyrinthitis 
Migraines

Question 4

What are the symptoms of BPPV?

Answer 4

<30 seconds of vertigo

Vertigo triggered by certain head positions

Question 5

How is BPPV diagnosed?

Answer 5

Dix-Hallpike manoeuvre

Question 6

What is the Dix-Hallpike manoeuvre?

Answer 6

Patients head turned to 45 degrees

Head is supported ad patient lowered to lie flat

Positive = vertigo + nystagmus

Question 7

How is BPPV managed?

Answer 7

Epley manoeuvre

Vestibular rehab

Question 8

What advice is given to patients with BPPV?

Answer 8

Reassure that it can be self limiting

Do not drive while dizzy

Avoid head movements that trigger dizziness

Question 9

How are patients followed up with BPPV?

Answer 9

Follow up repeat Dix-Hallpike 1-4 weeks later