Benign Paroxysmal Positional

What is BPPV?

Most common cause of vertigo due to a peripheral vestibular disorder

• Accounts for 20 -30% of all patients seen for vertigo

Common Causes of BPPV

• Head trauma (whiplash)
• Vestibular system degeneration, i.e. elderly
• Ear infections

Symptoms

Patients with BPPV complain of vertigo

• When bending forward
• Looking up
• Lying down
• Rolling over in bed

Two different mechanisms

Both involve calcium carbonate crystals and float into one of three semi-circular canals

• Canalithiasis – free floating crystals. Possible recurrence in 40% of patients. Patients are taught the treatment maneuver.
• Cupulolisthiasis – Usual resolved with one (1) treatment.

Treatment

• This is a biomechanical problem and can only be resolved when the patient is taken through a series of head positions to dislodge the crystals
• Patients must limit their head movements following the treatment; therefore, they are unable to drive and must be accompanied to the clinic