The gold standard diagnosis for benign paroxysmal positional vertigo

Abstract

Objectives. The purpose of this paper is to improve quality of care for posterior canal BPPV patients by making an accurate and efficient diagnosis and by decreasing the inappropriate use of expensive tests such as radiographic imaging and vestibular testing. Method and materials. The study was conducted in our clinic on a group of 82 BPPV patients over an eleven months time frame between January 2011 and November 2011. The Dix-Hallpike maneuver was applied to each patient. Results were statistically analyzed with the program Microsoft Excel 2003. Results. Out of the 82 patients 90% were diagnosed with posterior canal BPPV by performing the Dix-Hallpike maneuver, another 9% of the patients had horizontal canal BPPV and only 1% had superior canal BPPV. 76 patients were found in stable condition at the follow-up control one week after the repositioning maneuvers. This demonstrates a 92,6% rate of success of this treatment following a correct diagnosis. Conclusions. The Dix-Hallpike maneuver represents the “gold standard” diagnosis for posterior canal BPPV. Therefore, the use of expensive investigation such as computerized tomography and magnetic resonance imaging can be limited and the time for establishing the diagnosis for BPPV patients can be reduced, allowing a quicker treatment of this condition.

Keywords

• vertigo
• dix-hallpike maneuver
• semicircular canals
• nystagmus
• otoconia