BPPV

Question 1

What is BPPV?

Answer 1

A common cause of recurrent vertigo symptoms triggered by head movement

Question 2

Where is the cause of the vertigo?

Answer 2

Calcium carbonate crystals become displaced in the semicircular canals (usually posterior) which disrupts lymph flow through the canals and triggers the vertigo

Question 3

How does BPPV present?

Answer 3

• Episodic vertigo usually triggered by head movements e.g. turning over in bed
• Much more common in elderly patients
• Symptoms last between 20-60 seconds
• Symptoms often resolve with periods of norm and then reoccur
• NO HEARING LOSS OR TINNITUS

Question 4

How is BPPV diagnosed?

Answer 4

Dix-Hallpike manoeuvre -> moving the head in a certain way triggers the movement of the endolymph which triggers vertigo symptoms

Question 5

How is BPPV managed?

Answer 5

• Epley manoeuvre -> moving the head in a way where the crystals are moved out of the semi-circular canals
• Patients can be Brandt-Daroff exercises at home
• Medications such as Betahistine can be prescribed but are usually not helpful