Benign Paroxysmal Positional Vertigo

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Benign Paroxysmal Positional Vertigo

  1. 1. BENIGN PAROXYSMALPOSITIONAL VERTIGO (BPPV) Col Dr Anwar ul Haq ENT Consultant +923018513303
  2. 2. BPPV-DefinitionA self-limited condition characterizedby episodic vertigo and nystagmus ofbrief duration. It is provoked byassuming very specific head positions
  3. 3. EPIDEMIOLOGYThe most commonly recognized vestibulardisorderThe mean age at onset was 54 years, witha range of 11 to 84 years107 cases per 100,000 populations peryear
  4. 4. PATHOPHYSIOLOGYThe prevailing theory of BPPV is thatotoconia (calcium particles) are shed fromthe utricular macula and migrate to theposterior semi-circular canal.
  5. 5. PATHOPHYSIOLOGYCupulolithiasisOtoconia particles may settle into thesensory organ cupula of the posteriorsemi-circular canalCanalithiasisOtoconia continue to free float within theendolymph of the posterior canal
  6. 6. AETIOLOGYIdiopathicHead injuryViruses affecting the earSurgery
  7. 7. CLINICAL FEATURESVertigoLight-headednessImbalanceNauseaIntermittent pattern
  8. 8. DIAGNOSISHISTORY AND PHYSICALEXAMINATIONDIX-HALLPIKE TEST
  9. 9. MANAGEMENT
  10. 10. PHYSICAL MANOEUVRESEXERCISESSURGERY
  11. 11. EPLEY(CRP) MANOEUVRE
  12. 12. PARTICLE RRPOSITIONUNG MANOEUVRE(PRM)
  13. 13. SEMONT MANOEUVRE
  14. 14. POST MANOEUVRE INSTRUCTIONSWait for 10 minutes after the manoeuvre isperformedDont let the patient to driveSleep semi-recumbent for the next twonightsFor at least one week, avoid provokinghead positions
  15. 15. BRANDT-DAROFF EXERCISE STEPS
  16. 16. SURGICAL TREATMENT OF BPPVSingular NeurectomyVestibular Nerve SectionPosterior canal plugging
  17. 17. ATYPICAL BPPVLateral canal BPPVAnterior canal BPPVMulticanal patterns.
  18. 18. THANK YOU

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