Benign Paroxysmal Positional Vertigo

Selena E. Heman-Ackah

in Neurotology

Published on behalf of Oxford University Press

Published in print October 2014 | ISBN: 9780199843985
Published online November 2014 | e-ISBN: 9780199348992 | DOI:

Series: What Do I Do Now

Benign Paroxysmal Positional Vertigo

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Benign paroxysmal positional vertigo (BPPV) is caused by displacement of otolith due to either canalithiasis or cupulolithiasis and is usually idiopathic, possibly viral or traumatic, and represents the most common form of vertigo in the USA. It is characterized by vertigo lasting seconds following head position change. The Dix-Hallpike maneuver reveals fatigable rotary nystagmus, which is pathognomonic for BPPV. BPPV is classified according to the semicircular canal involved, usually the posterior one. Radiologic or cochleovestibular studies are rarely needed since the diagnosis is readily made on neurologic exam. Treatment is supportive, vestibular therapy, and most importantly the canal repositioning maneuvers involving the otolith of the canal involved. Surgery is rarely required and the recurrence rate of BPPV is about 15% thus therapy may need to be repeated multiple times. The clinical presentation, diagnosis, and treatment of BPPV including otolith repositioning therapy are discussed.

Chapter.  1305 words.  Illustrated.

Subjects: Neurology

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