benign paroxysmal positional vertigo treatment

This triggers transmission of neural signals to the brain to initiate appropriate reflex responses for the eyes, head, and postural adjustments. Other pertinent medical history, such as issues with vision, disabilities of the lower extremities, medications that can cause dizziness, diabetes, neuropathy, cerebrovascular disease, stroke, neck pain, seizures, hypertension, cardiac problems, or ototoxicity.Ĭommon vestibular disorders have typical characteristics ( Table 1) 3, 4 that are key to quickly narrowing down the cause of symptoms and making appropriate referrals.īody movements cause the fluid in the semicircular canals to move and stimulate cilia on sensory hair cells.

Time course of symptoms, such as speed of onset, duration, the circumstance of onset, time since the initial episode, and frequency of episodesĪssociated factors, such as migraine or changes in vision, hearing, or breathingĮxacerbating and relieving factors, such as head or body movements, closing or opening the eyes, looking in one direction or another, entering or leaving a busy visual field, coughing, sneezing, or loud sounds Quality of symptoms, such as vertigo, oscillopsia (the illusion that objects are moving back and forth), general imbalance, or lightheadedness 2Ī thorough case history can differentiate between these sensations and point to a cause. Dizziness is any distortion of the sensation of where one is within a space, whereas vertigo is a false sensation of movement, specifically rotation or spinning. Patients use the term dizziness to describe several different sensations, but medically speaking it is different from vertigo.

We also discuss how best to treat it, also with position-changing maneuvers. This article provides an update on benign paroxysmal positional vertigo (BPPV), a common balance disorder, and how to distinguish it from other causes of dizziness, vertigo, and imbalance with easy position-changing maneuvers. The symptoms can also be similar to those of life-threatening conditions, making the diagnostic workup challenging. Unfortunately, balance disorders are often difficult to diagnose and manage, owing in part to the subjective symptoms and the complexity of the neurologic, cardiovascular, metabolic, toxic, vestibular, and psychiatric conditions that can cause them. 1 It is the reason for many emergency room visits, secondary to benign conditions (eg, vestibular conditions, migraine, psychogenic conditions) and serious conditions (eg, stroke, inflammatory central nervous system disease, intracranial tumor, or hemorrhage). If repositioning maneuvers do not relieve the symptoms, a full workup, including radiographic imaging and a vestibular test battery, should be considered.ĭizziness is a common complaint that can affect people of all ages: roughly 15% of American adults report a balance or dizziness problem. Treatment can be done by a general practitioner or by a specialist in vestibular rehabilitation or vestibular audiology. The condition is easily diagnosed with the Dix-Hallpike and supine roll maneuvers. BPPV symptoms typically last seconds to minutes and are not associated with hearing loss or other neurologic signs or symptoms.ĭizziness or vertigo when lying down or changing positions is a strong predictor of BPPV.

Benign paroxysmal positional vertigo treatment