scholarly journals The Dix-Hallpike and Modified Epley Manoeuvres in the diagnosis and management of Benign Paroxysmal Positional Vertigo (BPPV)

2004 ◽  
Vol 3 (1) ◽  
pp. 36-37
Author(s):  
Matthew Clarke ◽  
◽  
Liz Stallworthy ◽  
J Dulay ◽  
◽  
...  
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
Head Position ◽  
Balance Disorders ◽  
Diagnosis And Management ◽  
Positional Vertigo ◽  
Rapid Changes ◽  
Common Balance ◽  
Paroxysmal Positional Vertigo

Benign Paroxysmal Positional Vertigo (BPPV) is one of the most common balance disorders and one of the easiest to diagnose and treat. It is characterised by short lived episodes of vertigo and geotropic rotatory nystagmus, which occur a few seconds after rapid changes in head position. The vertigo usually lasts no more than a minute and the symptoms reduce in severity with repetitions of the evoking movement.

scholarly journals Benign Paroxysmal Positional Vertigo Treated with Maneuvers to Change Head Position.

1995 ◽  
Vol 88 (7) ◽  
pp. 857-862
Author(s):  
Takayoshi ITAYA ◽  
Hiroya KITANO ◽  
Yoshiro YAZAWA ◽  
Akira KODAMA ◽  
Ichiro KOMADA ◽  
...  
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
Head Position ◽  
Positional Vertigo ◽  
Paroxysmal Positional Vertigo

Treatment of Objective and Subjective Benign Paroxysmal Positional Vertigo

2013 ◽  
Vol 24 (07) ◽  
pp. 600-606 ◽  
Author(s):  
Alexandra C. Huebner ◽  
Susan R. Lytle ◽  
Steven M. Doettl ◽  
Patrick N. Plyler ◽  
James T. Thelin
Keyword(s):  
Repeated Measures ◽  
Benign Paroxysmal Positional Vertigo ◽  
Head Position ◽  
Subjective Report ◽  
Repeated Measures Design ◽  
Positional Vertigo ◽  
Data Collection And Analysis ◽  
Significant Difference ◽  
Before And After ◽  
Paroxysmal Positional Vertigo

Background: Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo in adults and is a result of otolithic particles or debris that become free floating within a semicircular canal or adhere to the cupula. Characteristics of BPPV include brief episodes of latent onset vertigo that occur with changes in head position, transient rotary nystagmus beating toward the dependent ear, and reversed nystagmus upon sitting up. Both the vertigo and nystagmus fatigue quickly while maintaining the same head position. The BPPV may be classified as objective or subjective. Objective BPPV presents all the aforementioned symptoms whereas subjective BPPV presents all the symptoms without nystagmus. The accepted method of treatment for objective BPPV is canalith repositioning maneuvers (CRM); however, CRM are not traditionally used as the method of treatment for cases of subjective BPPV. Purpose: The purpose of the study was to determine if the subjective report of dizziness using the Dizziness Handicap Inventory (DHI) was different in patients with objective and subjective BPPV and to determine if the two groups showed similar improvements in perceived dizziness handicap following CRM treatment. Research Design: The present study utilized a retrospective, repeated measures design. Study Sample: Sixty-three adults with BPPV that were given the DHI both before and after CRM treatment. Data Collection and Analysis: Pre and post DHI results were analyzed for participants with objective versus subjective BPPV. A five-question DHI subscale was also analyzed between the groups. Results: A significant difference was noted between initial and posttreatment DHI scores for patients in both the subjective and objective groups when using the full-scale and subscale DHI. No significant difference was noted between groups for their initial or posttreatment DHI scores. The two groups also did not differ significantly in their initial or posttreatment DHI subscale scores. Conclusions: The results of the study indicated that individuals with both objective and subjective BPPV demonstrated significant improvement in DHI scores following CRM treatment. Additionally, there was no difference in DHI improvement for the subjective versus objective group suggesting CRM are effective for both subjective BPPV and objective BPPV. This improvement in DHI scores was also noted in the five-question DHI subscale with no significant difference noted between groups. These findings combined with previous studies suggest the presence or absence of nystagmus during Dix-Hallpike maneuvers is not related to the effectiveness of treatment using CRM.

scholarly journals Prevalence of Pediatric and Adolescent Balance Disorders: Analysis of a Mono-Institutional Series of 472 Patients

Children ◽  
2021 ◽  
Vol 8 (11) ◽  
pp. 1056
Author(s):  
Cristiano Balzanelli ◽  
Daniele Spataro ◽  
Luca Oscar Redaelli de Zinis
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
Clinical History ◽  
Diagnostic Process ◽  
Clinical Documentation ◽  
Vestibular Loss ◽  
Balance Disorders ◽  
Positional Vertigo ◽  
Diagnostic Work ◽  
Work Up ◽  
Paroxysmal Positional Vertigo

(1) Background: To assess the prevalence and frequency distribution of balance disorders in children and adolescents to delineate the planning of a targeted clinical and instrumental diagnostic work-up; (2) Methods: Retrospective analysis of the clinical documentation of patients under 18 years suffering from balance disorders from 2010 to 2019. Detailed collection of clinical history, accurate clinical examination, including both nystagmus and vestibulospinal signs examinations, and specific instrumental testing were the basis of the diagnostic process. (3) Results: A total of 472 participants were included in the study. Vestibular loss (26.1%) was the most frequent cause of vertigo in children, followed by vestibular migraine (21.2%) and benign paroxysmal positional vertigo (10.2%). In 1.1% of patients, the cause of vertigo remained undefined; (4) Conclusions: The diagnostic process applied was effective in understanding the cause of balance disorders in most cases and prevents more complex and expensive investigations reserved for only a few selected cases.

scholarly journals Teaching Patient-Centered Counseling Skills for Assessment, Diagnosis, and Management of Benign Paroxysmal Positional Vertigo

2018 ◽  
Vol 39 (01) ◽  
pp. 052-066 ◽  
Author(s):  
Richard Roberts ◽  
Carole Johnson ◽  
Anna Jilla
Keyword(s):  
Experiential Learning ◽  
Clinical Education ◽  
Benign Paroxysmal Positional Vertigo ◽  
Learning Opportunities ◽  
Primary Concern ◽  
Vestibular Disorder ◽  
Patient Centered ◽  
Diagnosis And Management ◽  
Positional Vertigo ◽  
Paroxysmal Positional Vertigo

AbstractAudiologists are an integral part of the management of those with dizziness and vestibular disorders. However, little research has been performed on counseling approaches for patients who present with dizziness as a primary concern. Accordingly, it is important that audiology students are provided with didactic and experiential learning opportunities for the assessment, diagnosis, and management of this population. Benign paroxysmal positional vertigo is the most common vestibular disorder among adults. Doctor of Audiology students, at a minimum, should be provided with learning opportunities for counseling patients with this particular disorder. Implementation of patient-centered counseling is applied across various parts of the patient encounter from initial intake to treatment and patient education. The purpose of this article is to present the available evidence and to apply widely accepted theories and techniques to counseling those with benign paroxysmal positional vertigo. Didactic resources and experiential learning activities are provided for use in coursework or as a supplement to clinical education.

Unrecognized benign paroxysmal positional vertigo in elderly patients

2000 ◽  
Vol 122 (5) ◽  
pp. 630-634 ◽  
Author(s):  
John S. Oghalai ◽  
Spiros Manolidis ◽  
Justine L. Barth ◽  
Michael G. Stewart ◽  
Herman A. Jenkins
Keyword(s):  
Elderly Patients ◽  
Benign Paroxysmal Positional Vertigo ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Geriatric Population ◽  
Cross Sectional ◽  
Balance Disorders ◽  
Positional Vertigo ◽  
Increased Risk ◽  
Paroxysmal Positional Vertigo

Balance disorders in elderly patients are associated with an increased risk of falls but are often difficult to diagnose because of comorbid chronic medical problems. We performed a cross-sectional study to determine the prevalence of unrecognized benign paroxysmal positional vertigo (BPPV) and associated lifestyle sequelae in a public, inner-city geriatric population. Dizziness was found in 61% of patients, whereas balance disorders were found in 77% of patients. Nine percent were found to have unrecognized BPPV. Multivariate analysis demonstrated that the presence of a spinning sensation and the absence of a lightheadedness sensation predicted the presence of unrecognized BPPV. Patients with unrecognized BPPV were more likely to have reduced activities of daily living scores, to have sustained a fall in the previous 3 months, and to have depression. These data indicate that unrecognized BPPV is common within the elderly population and has associated morbidity. Further prospective studies are warranted.

Relationship between the affected ear in benign paroxysmal positional vertigo and habitual head-lying side during bedrest

2006 ◽  
Vol 120 (7) ◽  
pp. 534-536 ◽  
Author(s):  
B Ö Çakir ◽  
İ Ercan ◽  
Z A Çakir ◽  
Ş Civelek ◽  
S Turgut
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
Prospective Trial ◽  
Head Position ◽  
Posterior Semicircular Canal ◽  
Positional Vertigo ◽  
Head Positioning ◽  
Falling Asleep ◽  
The Right ◽  
Lateral Head ◽  
Paroxysmal Positional Vertigo

Objective: To assess the association between the habitual head position during bedrest and the affected ear in benign paroxysmal positional vertigo (BPPV).Study design: Prospective trial of patients with active BPPV of the posterior semicircular canal, confirmed on physical examination.Methods: Seventy-five patients were asked to explain the head position and lying side they were accustomed to before falling asleep in bed.Results: Fifty patients (67 per cent) habitually adopted a lateral head position during bedrest. The ear affected by BPPV was found to be consistent with the head-lying side during bedrest in 43 cases (86 per cent) (29 cases for the right ear and 14 cases for the left ear).Conclusion: Habitual lateral head-positioning during bedrest can be a major factor leading to the development of BPPV in the ipsilateral ear.

scholarly journals Effect of Sitting Position vs. Supine Position With the Head Turned to the Affected Side on Benign Paroxysmal Positional Vertigo Fatigue

2021 ◽  
Vol 12 ◽  
Author(s):  
Takao Imai ◽  
Suetaka Nishiike ◽  
Tomoko Okumura ◽  
Noriaki Takeda ◽  
Takashi Sato ◽  
...  
Keyword(s):  
Supine Position ◽  
Benign Paroxysmal Positional Vertigo ◽  
Head Position ◽  
Sitting Position ◽  
Positional Nystagmus ◽  
Positional Vertigo ◽  
Affected Side ◽  
Group A ◽  
Group B ◽  
Paroxysmal Positional Vertigo

Objective: In benign paroxysmal positional vertigo (BPPV), positional nystagmus becomes generally weaker when the Dix–Hallpike test is repeated. This phenomenon is termed BPPV fatigue. We previously reported that the effect of BPPV fatigue deteriorates over time (i.e., the positional nystagmus is observed again after maintaining a sitting head position). The aim of this study was to investigate whether the effect of BPPV fatigue attenuates after maintaining a supine position with the head turned to the affected side.Methods: Twenty patients with posterior-canal-type BPPV were assigned to two groups. Group A received Dix–Hallpike test, were returned to the sitting position (reverse Dix–Hallpike test) with a sitting head position for 10 min, and then received a second Dix–Hallpike test. Group B received Dix–Hallpike test, were kept in the supine position with the head turned to the affected side for 10 min, and then received reverse Dix–Hallpike test followed by the second Dix–Hallpike test. The maximum slow phase eye velocity (MSPEV) of positional nystagmus induced by the first, reverse, and second Dix–Hallpike test were analyzed.Results: The ratio of MSPEV of the positional nystagmus induced by the second Dix–Hallpike test relative to the first Dix–Hallpike test was significantly smaller in group B than that in group A. There was no difference in the MSPEV of the positional nystagmus induced by the reverse Dix–Hallpike test between group A and B.Conclusions: The effect of BPPV fatigue is continued by maintaining a supine position with the head turned to the affected side, while the effect is weakened by maintaining a sitting head position. On the basis of the most widely accepted theory of the pathophysiology of BPPV fatigue, in which the particles become dispersed along the canal during head movement in the Dix–Hallpike test, we found an inconsistency whereby the dispersed otoconial debris return to a mass during the sitting position but do not return to a mass in the supine position with the head turned to the affected side. Future studies are required to determine the exact pathophysiology of BPPV fatigue.Classification of Evidence: 2b.

scholarly journals Benign paroxysmal positional vertigo

2011 ◽  
Vol 02 (01) ◽  
pp. 109-110 ◽  
Author(s):  
Xiang-Dong Guo
Keyword(s):  
Recurrence Rate ◽  
Successful Treatment ◽  
Benign Paroxysmal Positional Vertigo ◽  
Head Position ◽  
Clinical Disorder ◽  
Positional Vertigo ◽  
Multiple Recurrences ◽  
Unnecessary Testing ◽  
Paroxysmal Positional Vertigo

ABSTRACTBenign paroxysmal positional vertigo (BPPV) is a common clinical disorder characterized by brief recurrent spells of vertigo often brought about by certain head position changes as may occur with looking up, turning over in bed, or straightening up after bending over. It is important to understand BPPV not only because it may avert expensive and often unnecessary testing, but also because treatment is rapid, easy, and eff ective in >90% of cases. The diagnosis of BPPV can be made based on the history and examination. Patients usually report episodes of spinning evoked by certain movements, such as lying back or getting out of bed, turning in bed, looking up, or straightening after bending over. At present, the generally accepted recurrence rate of BPPV after successful treatment is 40%–50% at 5 years of average follow-up. There does appear to be a subset of individuals prone to multiple recurrences..

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