Benign paroxysmal positional vertigo (BPPV)
What is it?
Benign paroxysmal positional vertigo (BPPV) is the most frequent cause of peripheral vertigo, which incidence increases with age, reaching the highest prevalence in people over 70 years old. Vertigo is related to the detachment of calcium salts concretions called otocones present in a part of the inner ear and their passage in one of the semicircular canals. The main cause of detachment of the otocones is still idopathic, other possible etiologies are dysmetabolic (reduced levels of calcium and vitamin D), and post-traumatic (head trauma). It is easily suspected from the clinical history of violent but short-term vertigo triggered by lying on one side in bed.
Which are the symptoms?
The main symptom is rotatory vertigo lasting a few minutes exacerbated by head movements and/or triggered by the acquisition of a particular posture associated with nausea and/or vomiting.
- Rotatory vertigo
- Nausea and/or vomiting
- Instability
How is it diagnosed?
To date, this pathology can be diagnozed by correct anamnestic collection of the patient's clinical history and symptoms, in addition to the execution of certain diagnostic positioning maneuvers (Dix-Hallpike maneuver, Pagnini-McClure maneuver).
How is it treated?
The treatment of benign positional paroxysmal vertigo involves the execution of specific liberating maneuvers (e.g. Semont maneuver, Epley maneuver, etc.) performed on the basis of the involvement of a specific semicircular canal. Pharmacological medical treatments can also be used in order to reduce the sense of residual instability that may persist for days after the maneuvers are performed.
Where do we treat it?
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