Graded A+
BPPV - Answersbenign paroxysmal positional vertigo
BPPV(Benign Paroxysmal positional vertigo) means what? - Answersis not life threatening, s/s come and
go, certain positions flare up. Can treat/cure after 1-2 office visits. Its benign natures makes it unique to
other vestibular issues
These crystals are usually falling off and will be absorbed in body, but when there is chemical imbalance
or head injury that causes debris to fall off and become logged in canal or 2/2 otologic disorders. -
Answers
BPPV is diagnosed by what test - AnswersDix hall pike positioning maneuver
Dix-Hallpike maneuver - AnswersRapidly moving the pt from a sitting position to the supine position with
the head turned 45 degrees to the Right. After waiting apx. 20-30 sec, the pt is returned to the sitting
position. If no Nystagmus is observed, the procedure is then repeated on the Left side.
Keys S/S post Dix-Hallpike maneuver - Answerslatent onset 1-30 second of rotary torsional vertical
nystagmus (posterior and anterior canal ) OR Horizontal (horizontal canal) nystagmus with subjective
vertigo
Why are S/S latent post Dix Hallpike maneuver? - Answersit takes time for the crystals to fall
IF the posterior canal is affected during Dix Hallpike maneuver, how long will S/S last? - Answers10
seconds
IF the Horizontal canal is affected during Dix Hallpike maneuver, how long will S/S last? - Answersup to 1
minute
BPPV is caused by otoconia that have been displaced from the ______ and have entered one of the SCC.
- AnswersUtricle
Along with episodes of transient vertigo, BPPV may also cause: - AnswersElevated fall risk, nausea,
increased anxiety, elevated rates of depression, all of the above.
Effective treatment options for BPPV include: - AnswersCanalith repositioning maneuvers
The gold standard to treat BPPV: In office certified maneuvers, the first 3 will be taught in hands on
class: - AnswersSemont Liberatory Maneuver
Modified Canalift repositioning maneuver (Modified Epley / Herdman ET AL)
Gans Repositioning Maneuver
Casani Maneuver
, Appiani Maneuver
Horizontal Hybrid maneuver
BBQ/Logroll Maneuver
Name 3 tests we will review to treat BPPV - Answers-Semont Liberatory Maneuver
-Modified Canalift repositioning maneuver (Modified Epley / Herdman ET AL)
-Gans Repositioning Maneuve
Canalithiasis - AnswersVariant of BPPV where otoconia are free floating within the semicircular canal
If Right or left horizontal SCC is affected, what type of nystagmus will be present - AnswersHorizontal
Nystagmus
Name Systemic non-otological factors associated with BPPV - Answers-Cardiovascular disease-
impedance of blood flow affects debris that will get into the SCC;
-Head Trauma- more likely to be multi SCC, more challenging, more likely bilaterally;
Migraine- thought to cause issues with ion channels which are in the ear too,
Stroke- causes blood flow disturbances
How does Vitamin D factors associate with BPPV - Answerscrystals are made of calcium bicarbonate and
Vit D helps fluid system absorb calcium> so if dysregulation of Vit D and calcium>changes absorption
rate> endolymph is supposed to be calcium deprived so crystals can be reabsorbed by body when
sloughed off.
Our gold standard to treat BPPV is 1.25 treatments so if pt is recurrence, we tell them to go to Primary
care for VITAMIN D check up. Our positioning maneuvers will reposition crystals. - Answers
*Its only benign if you arent the one dealing with it - Answers
What canal tends to be the Cana mostly affected by BPPV? - AnswersPosterior Canal
The 2nd most commonly affected Canal affected by BPPV is - AnswersHorizontal