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Benign Paroxysmal Positional VertigoAka: Paroxysmal Positional Vertigo

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  1. See Also
    1. Vertigo
  2. Pathophysiology
    1. Ear trauma may precipitate
    2. Temporary displacement of otolith
      1. Displaced onto gelatinous capsule
      2. Involves posterior semicircular canal
    3. Symptoms persist until otolith (loose bodies) resorbed
  3. Symptoms
    1. Only change of head position triggers Vertigo
      1. Provoked by turning onto one side (not the other)
      2. Vertigo with vertical head movements
        1. Provoked by extending neck while looking up
      3. Recurs with similar movement
      4. Asymptomatic at rest
    2. Duration
      1. Environment spins for 10-20 sec, then resolves
    3. Timing
      1. Occurs at night while recumbent
  4. Signs
    1. Dix-Hallpike Maneuver elicits symptoms
  5. Differential Diagnosis
    1. See Vertigo Causes
    2. Diagnosis of exclusion
    3. Rule out CNS and Ear organic disease
  6. Management
    1. See Vertigo Management
    2. See Canalith Repositioning Procedure
    3. Supportive care
    4. Meclizine (Antivert)
    5. Diazepam
  7. Course
    1. Self limited
    2. Symptoms resolve in 4-6 weeks
    3. Prolonged disabling symptoms in 33% of patients
  8. References
    1. Baloh (1987) Neurology 37:371
    2. Baloh (1999) Postgrad Med 105(2):161

Benign paroxysmal positional vertigo (C0155502)

ConceptsDisease or Syndrome (T047)
ICD9386.11, 386.11
EnglishBenign paroxysmal positional nystagmus, Benign paroxysmal positional vertigo, BENIGN PARXYSMAL VERTIGO, BENIGN POSITIONAL VERTIGO, BPPV, BPPV - Benign paroxysmal positional vertigo
Spanishnistagmo posicional paroxistico benigno, vertigo posicional paroxistico benigno
Parent Concepts[X]Other peripheral vertigo (C0029706), Peripheral positional vertigo (C0456801), Acute disorder of ear (C1290844), Ambiguous concept (C1274012), Duplicate concept (C1274013)
SourcesCOSTAR, DXP, ICD9CM, MTHICD9, OMIM, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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