Benign Paroxysmal Positional Vertigo

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Benign Paroxysmal Positional Vertigo, BPPV or simply positional vertigo is a troublesome complaint. Patients complain of a sudden vertigo on a specific positional movement of the head. Typically it occurs when in bed when the patient rolls over to one side.The vertigo lasts for a few seconds then settles fairly quickly but during the episode the patient can be extremely troubled by the phenomenon.

Testing in clinic can be diagnosed by using the Dix Hallpike manouvre a rapid drop of the head whilst angled to one side. Small rythmic osscilations of the eyes are seen in the eyses (nystagmus) which settles rapidly.

The description of the cause is often said to be related to debris falling into one of the semicircular canals (organ of balance). On movement the debris is said to stimulate the semicircular canal balance mechanism. A manouvre reffered to as the Epley manouvre can be undertaken to move this debris out of the semicircular canal and out of harms way. This manouvre in my hands has a success rate in excess of 80% over 2 visits. Careful advice post Epley manouvre can allow for an increased chance of success.

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