EXAM 2 - BPPV Flashcards
what is the common complait of 65+ in the pCP office
dizziness
is dizzines ever normal
no
what is the most common cause of dizziness
medication
what is the basic definition of BPPV
when the inner ear send a signal to the brain that we are moving when the individual actually is not
otoconia crystal are moving in the canals - debris moving
what is the least common SCC involved in BPPV
superior canal
what is the reoccurrence rate of BPPV
15 % recurrency rate
what stop the spinning sensation in BPPV
then the debris stops moving
is everyone anaytomy of the inner ear the same
no
this may be a reason why people have different presentation
how long do BPPV symtoms last for
1 min
what if you see a case where the dizziness last for over an hour
central issue
it is more likely not BPPV
what is her def of BPPV
mechanical problem with the ear that can cause vertigo with positional chnages
what is BPPV casued by
free floating crystals - otoconia
what is assocciated with BPPV
- Age
- Upper respiratory illness, neuronitis, labyrinthitis
- TBI
- Postsurgical
- Meiners disease
- Migraines
- Osteoporosis/osteopenia
season and BPPV
lack of sun can contribute to BPPV
VIT D and BPPV
insuffiency in VIT D may contribute to this
only works if VIT D levels are low
gait ataxia is a sign of what kind of issue
central isssue not BPPV
how long do dizzy symptoms last in BPPV patients
1 min
provoking positions
getting out of bed
STS
bending over
looking up or reach overhead
rolling in bed
inablity to sleep wiht 3 pillows
freq of posterior canal BPPV
81-89%
posterior canal position of provaction
dix hall
nys seen with posterior canal BPPV
upbeating torsional
horizontal canal freq.
8-17%
horizontal canal provaction
roll test
horizontal canal nys
horizontal directional changing
ageotrophic and geotrophic
anterior canal BPPV freq.
1-3%
anterior canal BPPV provaction
dix hall
anterior canal nys
downbeating torsional
why do we perform the the modified dix hall pike
with the flexion of the neck there is more coverage fo the SCC compare to the standard Dix hall pike
what is vestibular agnosia
this is where people have nys but they do not spin
what causes vestibular agnosia
The connections between the parietal frontal area and the cortex are damaged
what is vestibular agnosia most often associated with
brain injury
what is the relationship between the side of a brain lesion and the side of the pt’s BPPV
none
they are not relateed
is nys without movement BPPV
no
geotropic nys - what direction is the fast phase
towards the ground
for agrotropic nys what direction is the fast phase
toward the ceiling
geotropic which side is affected
The side that has worse nys/symptoms is the involved ear
ageotropic which side is the effected side
the side has the better. nys/symptoms
what kind of nys do we see with HC BPPV
- Direction-changing positional nystagmus
do all pt that have BPPV complain of vertigo
no
some patient say they are spinning, lightheaded
fall risks and BPPV
people with BPPV are at a much higher risk for falls
does shaking the head udring the dix hall improve diagonosis rates
yes, can improve the chance by 15%
does vibration help does vibration help with repositioning
does not effect short term or long term of persons post repositioning
how many time should you perform these repositioning manuevers
we do not know - she does them twice
what is the most common canal involved in the BPPv presentation
right posterior canal
post repositioning should you tell the pt to sit upright for the next few days
no - this can be very difficult for the pt
we do not often provide much post repositioning instruction - other then no fast head movement
do postural restriction following repostioning help with pt outcomes
no
would you ever treat someone with a torn or detached retina before consulting someone
no - would not touch the pt with a poll
does BPPV take care of itself - no PT management
maybe
can you have BPPV in both ear at the same time
yes - normally occurs from head trauma
can you fix both BPPV presentation in one session
no - we normally treat one ear at a time
does BPPV run in families
yes, blood relatives are 5x more likely to get BPPV
canalithiasis
indicates free‐floating otoconia
canalithiasis - type of nystagmus
Geotropic nystagmus
cupulolithiasis
indicates otoconia stuck to the cupula
cupulolithiasis - type os nystagmus
apogeotropic nystagmu
