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Vertigo, Benign Paroxysmal Positional (BPPV)

Reviewed 06/2020
 


BASICS

DESCRIPTION

  • Benign paroxysmal positional vertigo (BPPV) is a mechanical disorder of the inner ear characterized by a brief period of vertigo experienced when the position of the patient’s head i...

DIAGNOSIS

  • The diagnosis is established based on history and findings on positional testing, clarified by Dix and Hallpike in 1952 (1,2)[A].

  • Positional tests place the plane of the canal being tested in...

TREATMENT

  • The C-reactive protein (CRP) or Epley maneuver is effective in the treatment of posterior canal BPPV (1)[A]. Using a particle repositioning maneuver, the clinician moves the patient through ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

The patient should follow up within a week after treatment to ensure resolution. 

PATIENT EDUCATION

A number of illustrative YouTube videos are available for educat...

REFERENCES

1
Helminski JO, Zee DS, Janssen I, et al. Effectiveness of particle repositioning maneuvers in the treatment of benign paroxysmal positional vertigo: a systematic review. Phys Ther.  20...

ADDITIONAL READING

Kattah JC, Talkad AV, Wang DZ, et al. HINTS to diagnose stroke in the acute vestibular syndrome: three-step bedside oculomotor examination more sensitive than early MRI diffusion-we...

CODES

ICD10

  • H81.10 Benign paroxysmal vertigo, unspecified ear

  • H81.12 Benign paroxysmal vertigo, left ear

  • H81.11 Benign paroxysmal vertigo, right ear

ICD9

386.11 Benign paroxysmal positional vertigo 

SNOMED

  • 1...

CLINICAL PEARLS

  • The diagnosis of BPPV is based on history and findings on positional testing.

  • The typical presentation is a report of transient episodes of vertigo (sensation that the room is spinning)...

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