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VERTIGO & The Epley Manoeuvre Dr Colin Mitchell SpR Geriatrics / GIM MSc Geriatric Medicine  (Special Senses Module)
Objectives ,[object Object],[object Object],[object Object],[object Object]
Vertigo ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Vertigo ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Peripheral Central
Peripheral vs Central ,[object Object],Peripheral Central Abrupt onset Intense Nausea / Vomiting Auditory complaints Associated with head position Usually more gradual onset Often less intense Less so Less often Constant / Non-positional
Peripheral vs Central ,[object Object],Peripheral Central Nystagmus - delayed, fatiguable (Torsional nystagmus) Auditory disturbance Nystagmus - immediate, non-fatiguable  (Vertical nystagmus) Other CN2-12 signs Other PNS signs esp ataxia
Causes of Vertigo ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Causes of Vertigo ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Causes of Vertigo ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
“ Benign” Paroxysmal Positional Vertigo
BPPV ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
BPPV Pathophysiology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Hallpike Test ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The Epley Manoeuvre ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The Epley Manoeuvre ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The Epley ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The Epley ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The Epley Video by Dr P Hain – see credits for attribution and web link
Evidence for Epley ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Cochrane Review ,[object Object]
Cochrane Review ,[object Object]
Non-specialists ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Other Treatments ,[object Object],[object Object],[object Object],[object Object],[object Object]
Summary ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Question Time
References ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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Tendances

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BPPV & The Epley Maneouvre / Maneuver