(BPPV) Benign Paroxysmal Positional Vertigo Epley Maneuver
Benign Paroxysmal Positional Vertigo Epley Maneuver (BPPV):-
- BPPV occurs in all ages but is more common in individuals over 50.
- Half of all cases are primary or idiopathic.
- Secondary causes include head injury, viral labyrinthitis, Meniere’s disease, migraine, and ear surgery.
- BPPV is usually easy to diagnose, and can often be treated using non-invasive techniques.
Patients experience episodes of rotational vertigo lasting less than a minute, which is precipitated by head movements. The episodes reoccur periodically over a period that may last weeks to months. There is often associated with nausea and vomiting.
BPPV is most commonly attributed to calcium carbonate crystalline debris from the utricular sac of the posterior semicircular canal. The semicircular canal in the ear detects angular head accelerations.
When this crystalline debris is displaced in response to provocative head movement, they cause excessive displacement of the sensory organ, or cupula and endolymph, via a plunger effect. This thing causes an erroneous sense of spinning. This process can happen with the interior, and well as horizontal semicircular canals.
Epley Maneuver How To Determine Which Side
The Dix Hallpike test can easily be performed to diagnose (Benign Paroxysmal Positional Vertigo Epley Maneuver) BPPV. While the patient is sitting upright, the head is positioned at 45 degrees to the horizontal. The patient is moved back into a supine position, with their head hanging off the examination table. This position is maintained for at least 30 seconds.
The test will elicit nystagmus and dizziness when the affected ear is in an inferior position. The patient is then brought back up into a sitting position, and nystagmus in this position is also diagnostic of BPPV.
The side-lying test, as shown here, is used if the patient cannot have hyperextended their neck or cannot lie on their back. Again, nystagmus and vertigo are checked after every change in position. Differential diagnosis of BPPV is vestibular neuronitis, Meniere’s disease., vertebrobasilar ischemia, migrainous vertigo, postural hypertension. BPPV is essentially a self-limiting disease. It often results spontaneously, even when untreated.
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The symptoms can take several weeks, months, or even years to resolve. It has a significantly negative impact on a patient’s quality of life. Vestibulum-sedatives, like betahistine, can be used in the treatment of (Benign Paroxysmal Positional Vertigo Epley Maneuver) BPPV. Unfortunately, these vestibular-suppressants have had limited success and may provide only minimal relief for some patients.
Benign Paroxysmal Positional Vertigo Exercises
The treatment is designed to treat the symptoms vertigo, and not the underlying cause itself, and often have undesirable side effects. Canalith repositioning is an important strategy in BPPV treatment. The diagram shown demonstrates the Epley’s maneuver for canalith repositioning for right canalithiasis.
This maneuver encourages the calcium deposits to migrate to [INAUDIBLE] of the anterior and posterior canals, and exit into the utricular cavity. The Modified Semont maneuver is reserved for patients who cannot hyperextend their neck, or lie on their backs. The patients can be taught the maneuvers for self-treatment.
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In summary, BPPV patients suffer intermittent episodes of vertigo, which are precipitated by head movements. The cause is usually of calcium carbonate debris within the posterior semicircular canal. The Dix Hallpike can help diagnose BPPV as the movement of debris in a semicircular canal thing.
Doing the test can cause nystagmus and vertigo. The most effective treatment is the Epley’s or Modified Semont maneuver, which aims to reposition the canalith to the utricular cavity. Other treatment, which is less effective, includes vestibulum-sedatives.