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Benign Paroxysmal Positional Vertigo
BENIGN
   PAROXYSMAL
POSITIONAL VERTIGO
          (BPPV)
    Col Dr Anwar ul Haq
      ENT Consultant
     +923018513303
BPPV-Definition
A self-limited condition characterized
by episodic vertigo and nystagmus of
brief duration. It is provoked by
assuming very specific head positions
EPIDEMIOLOGY
The most commonly recognized vestibular
disorder
The mean age at onset was 54 years, with
a range of 11 to 84 years
107 cases per 100,000 populations per
year
PATHOPHYSIOLOGY
The prevailing theory of BPPV is that
otoconia (calcium particles) are shed from
the utricular macula and migrate to the
posterior semi-circular canal.
PATHOPHYSIOLOGY
Cupulolithiasis
Otoconia particles may settle into the
sensory organ cupula of the posterior
semi-circular canal
Canalithiasis
Otoconia continue to free float within the
endolymph of the posterior canal
Benign Paroxysmal Positional Vertigo
Benign Paroxysmal Positional Vertigo
AETIOLOGY
Idiopathic
Head injury
Viruses affecting the ear
Surgery
CLINICAL FEATURES
Vertigo
Light-headedness
Imbalance
Nausea
Intermittent pattern
DIAGNOSIS
HISTORY AND PHYSICAL
EXAMINATION



DIX-HALLPIKE TEST
Benign Paroxysmal Positional Vertigo
Benign Paroxysmal Positional Vertigo
MANAGEMENT
PHYSICAL MANOEUVRES

EXERCISES

SURGERY
EPLEY(CRP) MANOEUVRE
PARTICLE RRPOSITIONUNG
   MANOEUVRE(PRM)
SEMONT MANOEUVRE
POST MANOEUVRE
        INSTRUCTIONS
Wait for 10 minutes after the manoeuvre is
performed
Don't let the patient to drive
Sleep semi-recumbent for the next two
nights
For at least one week, avoid provoking
head positions
BRANDT-DAROFF EXERCISE
        STEPS
SURGICAL TREATMENT OF
         BPPV
Singular Neurectomy
Vestibular Nerve Section
Posterior canal plugging
ATYPICAL BPPV

Lateral canal BPPV
Anterior canal BPPV
Multicanal patterns.
THANK YOU

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Benign Paroxysmal Positional Vertigo