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Vertigo, Benign Paroxysmal Positional (BPPV)

Chirag N. Shah, MD, Daniel E Levin, MD and Daniel Scott Morrison, Doctor of Medicine Reviewed 05/2023
 


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 (2,3)[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 (7)[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
Chen J, Zhao W, Yue X, et al. Risk Factors for the Occurrence of Benign Paroxysmal Positional Vertigo: A Systematic Review and Meta-Analysis. Front Neurol. 2020;11:506. doi:10.3389/fneur.2...

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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