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Benign paroxysmal positional vertigo

Benign paroxysmal positional vertigo (BPPV) describes a condition in which there is:
  • Rotational Vertigo 
  • Provoked by turning head/change in position 
  • Lasts around 10-30 seconds 
  • Possibly with nausea 

Most patients are over 40 years of age 
Women > men (2:1)

Aetiology – believed to be due to free-floating endolymph particles in semi-circular canal. 
  • Most cases (60-70%) are idiopathic
  • Secondary BPPV may be due to 
    • Head trauma (7-17% of all cases of BPPV) 
    • Viral (up to 15% of all cases of BPPV)
    • Meniere’s disease (around 5% of cases of BPPV) 
    • Migraines (less than 5% of all cases of BPPV) 

Diagnosis:  Dix-Hallpike manoeuvre – look for nystagmus 

Treatment: Epley’s manoeuvre – series of head movements with the purpose of encouraging any foreign material out of the canal and into the utricle 



References
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Secret collector of interesting anonymised ECGs. Fan of the Bath Photomarathon. Lover of cream teas. [Sarah Hudson] (Your Picture)