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Vertigo, Benign Paroxysmal Positional (BPPV)

Chirag N. Shah, MD, FACEP and Kyung In Yoon, MD Reviewed 06/2019
 


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 ...

TREATMENT

  • The 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 a series of positions...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

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

PATIENT EDUCATION

A number of illustrative videos are available at http://www.yout...

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

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

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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