Benign paroxysmal positional vertigo

Abstract

Benign paroxysmal positional vertigo (BPPV) is the leading etiology of peripheral vertigo. It manifests with transient, recurring bouts of vertigo brought on by movements of the head. BPPV happens when particles known as otoliths, which can either float freely (canalithiasis) or become attached to the cupula (cupulolithiasis), stimulate semicircular canals abnormally. The clinical symptoms of the BPPV are triggered when the head changes position so that the involved semicircular canal aligns vertically with gravity. During the Dix–Hallpike maneuver (used to diagnose posterior canal BPPV) and the supine roll test (used to diagnose horizontal canal BPPV), patients typically experience a brief delay followed by acute vertigo and nystagmus. Reversing the head position often causes the nystagmus to change direction. The location of otolith debris and the semicircular canal that is affected determine the severity, frequency, and length of symptoms in BPPV. There may be a spontaneous recovery of the BPPV with the help of conservative treatments. However, an important treatment option such as the canalith repositioning maneuver is helpful for giving an immediate resolution of the symptoms by clearing otolithic debris from the semicircular canal into the vestibule. This review article will discuss the prevalence, etiopathology, clinical features, differential diagnosis, and management of different types of BPPV including medical and surgical treatment and rehabilitation for BPPV.

Keywords

• benign paroxysmal positional vertigo
• epley’s maneuver lateral canal benign paroxysmal positional vertigo
• posterior canal benign paroxysmal positional vertigo