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Benign Paroxysmal Positional Vertigo

Benign paroxysmal positional vertigo is a form of vertigo that usually lasts less than 30 seconds, but happens intermittently. It originates from the inner ear where there are otoconia or “ear rocks”. They originate from degenerative changes of the lining inside the balance organ and get stuck in one position, essentially giving false signals to the brain regarding the body balance (position in space). This causes confusion and dizziness as the signals from the eyes are not in agreement with the signals generated by the balance organs.

Head trauma, middle ear infection and a closing off of the vestibular artery have all been implicated as causes of this condition.

Symptoms

this condition occurs when the patient extends the head backwards or when the patient lies on one ear. At the same time nystagmus (rapid jerky eye movements) may occur.

Diagnostic test

Provocative tests are done looking for nystagmus and benign paroxysmal positional vertigo with sudden positional changes. The otolaryngologist will want to also order an MRI scan of the head to rule out an acoustic neuroma or other serious abnormality.

Treatment

The condition often subsides on its own in several months or a few years. A special positional desensitisation technique (thanks to www.medicalook.com for this link) has been introduced by physiotherapists, which is quite effective in a large percentage of patients (Ref. 3, p.679). It is called canalith repositioning procedure.

You can find more detailed info about this condition (thanks to www.tchain.com for this link) through this link.

 Benign Paroxysmal Positional Vertigo

Benign Paroxysmal Positional Vertigo

 

References:

1. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 84.

2. Noble: Textbook of Primary Care Medicine, 3rd ed.,2001, Mosby Inc.

3. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 85.

4. Rakel: Conn’s Current Therapy 2001, 53rd ed.,2001, W. B. Saunders Company

5. Goldman: Cecil Textbook of Medicine, 21st ed.,2000, W. B. Saunders Company

6. Mandell: Principles and Practice of Infectious Diseases, 5th ed.,2000, Churchill Livingstone, Inc.

7. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 265.

8. MF Williams: Otolaryngol Clin North Am; Oct1999; 32(5): 819-834.

9. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 106.

10. Ferri: Ferri’s Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.

11. Rakel: Conn’s Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier

Last modified: October 24, 2014

Disclaimer
This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.