BPPV (Benign Paroxysmal Positional Vertigo)

Question 1

Definition

Answer 1

Mechanical vestibular health condition on the PNS. Usually only affects 1 side

Question 2

PNS or CNS

Answer 2

PNS

Question 3

Subclassifications (types)

Answer 3

Posterior semicircular canal - most common
Horizontal canal
Anterior semicircular canal

Question 4

Cause

Answer 4

• most commonly idiopathic
  
  • older age >65 prevalence increases
• trauma (i.e head trauma)
• vestibular neuritis (inflammation reduces adhesiveness of gel-like substance)

Question 5

Pathophysiology

Answer 5

Caused by displacement of otoconia into the semicircular canals, normally in the utricle and saccule.

Otoconia becomes detached from gel-like substance and floats into endolymphatic fluid (freely around division)

Crystals enter the SC, making the SC sensitive to gravity

Question 6

How is it diagnosed (objective and subjective)

Answer 6

Objective
- Dix hallpike: positive

• eye ax: negative
• Head impulse test (VOR) - negative

Subjective:

• dizziness = environment around them moving
• dizziness last less than a minute

Question 7

How long does dizziness last?

Answer 7

LESS than a minute

Question 8

Problems

Answer 8

Vertigo
- onset with change in position

Nystagmus: torsional - vertical (rotatory)

+/- decreased balance - postural instability
+/- nausea and vomiting

Question 9

Describe a general subjective assessment of Vestibular conditions

Answer 9

1. describe dizziness without using the word dizzy
2. episodes of dizziness:
   
   • 1st and most recent in detail
   • little bit of detail of episodes between
3. temporal aspect (duration) dizziness
   
   • over a minute or less than a minute

Question 10

Describe a general objective assessment of Vestibular conditions + purpose of each test

Answer 10

1. Eye Ax = 1st position (spontaneous nystamus) + T, X (gaze-evoked nystagmus)
2. Head impulse test = checking integrity of VOR
3. Dix-hallpike = checking for BPPV