Benign Paroxysmal Positional Vertigo or BPPV. This post will cover the points you need to know for your board exams as well as for teaching residents on the daily rounds. Please don't use the information here to treat your patients.
BPPV is the most common cause of vertigo. It is twice more common in women. Most commonly occur due to sudden head movement. Recurrence rate is up to 50%. Symptoms will range from days to months. No imaging or medication is indicated or even recommended for the condition itself, however, treat associated severe symptoms like nausea with appropriate medication if present. Diagnosis is by Dix-Hallpike maneuver which induce vertigo and nystagmus. Treatment in is usually by Canalith Reposition Procedures (CRP) of which the most famous is Epley maneuver and Half Somersault Maneuver with follow up in one month.
According to the American Academy of Otolaryngology-Head and Neck Surgery guidelines as of 2024, it is not recommended to start the patient on medications like antihistaminic and benzodiazepines as those vestibular suppressive medications will interfere with the way the CNS compensate to the vestibular trauma and lead to other unwanted side effects and outcomes.
According to some non-medical internet sources, some people has been finding some success with using devices designed for BPPV like DizzyFIX.
Patients also found this Understanding BPPV book by Prof Mark Knoblauch helpful in coping with this condition as well as Overcoming Positional Vertigo by Dr Carol Foster.
The information in this post is not for patients and shouldn't be used in treating patients. Please refer to your doctor for medical advice.