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Vertigo, Benign Paroxysmal Positional (BPPV)

Chirag N. Shah, MD and Kyung In Yoon, MD Reviewed 06/2022
 


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 i...

TREATMENT

  • The CRP or Epley maneuver is effective in the treatment of posterior canal BPPV (6)[A]. Using a particle repositioning maneuver, the clinician moves the patient through a series of position...

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
Devaiah AK, Andreoli S. Postmaneuver restrictions in benign paroxysmal positional vertigo: an individual patient data meta-analysis. Otolaryngol Head Neck Surg. 2010;142(2):155–159. 
2
Halke...

ADDITIONAL READING

Epley JM. The canalith repositioning procedure: for treatment of benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg. 1992;107(3):399–404.  ...

CODES

ICD10

  • H81.10 Benign paroxysmal vertigo, unspecified ear

  • H81.12 Benign paroxysmal vertigo, left ear

  • H81.11 Benign paroxysmal vertigo, right ear

SNOMED

  • 111541001 benign paroxysmal positional vertigo (d...

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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