Neurology\ Benign Paroxysma Positional Vertigo

Question 1

What movement tend to trigger vertigo in Benign Paroxysmal Positional Vertigo (BPPV)?

Answer 1

• looking up while standing or sitting
• getting up from bed (symptoms are often in the morning)
• rolling over in bed.

Question 2

What causes the BPPV? c

Answer 2

• Calcium debris (canalithiasis) within semicircualar canal of the inner ear (often the posterior canal) that causes movement of the endolymphy

Question 3

Patients with BPPV commonly report ear pain, hearing loss and tinnitus. True or False?

Answer 3

False ear pain hearing loss and tinnitus are uncommon with BPPV.

Question 4

What is the name of the maneuver that is used to help confirm the diagnosis of BPPV?

Answer 4

• Dix-Hallpike maneuver.

Question 5

Describe the Dix-Hallpike maneuver

Answer 5

1. Have seated patien extend neck and rotate head 45 degrees to one side
2. then rapidly placed the patient supine, so that the head, hence over the edge of the table (head remains rotated)
3. observe for nystagmus for 30 seconds
4. return the patient to the upright position
5. and observe for the stigmas for 30 seconds
6. Repeat the maneuver with the head rotated 45 degrees to the other side.

Question 6

What is the positive test for a Dix-Hallpike maneuver?

Answer 6

• nystagmus and vertigo.

Question 7

Does a negative Dix-Hallpike rule out BPPV ?

Answer 7

• No, the Dix-Hallpike maneuver does not reliably reproduce symptoms in all patients,

Question 8

the nystagmas associated with BPPV is fatigue trouble. True or False?

Answer 8

• True. Multiple repetitions of the test will result in less nystagmus.
• Also, the nystagmus elicited by Dix-Hallpike maneuver can be delayed.

Question 9

What maneuvers can treat BPPV?

Answer 9

• The Epley and Semont maneuvers.

Question 10

How long do BPPV symptoms persist without treatment?

Answer 10

• symptoms in patients with untreated posterior canal BPPV last for approximately a month before resolving spontaneously.