Podcast 1020: Benign Paroxysmal Positional Vertigo (BPPV)

Contributor: Alec Coston, MD

Educational Pearls:

Benign Paroxysmal Positional Vertigo (BPPV)

Common inner ear condition that can cause dizziness

Diagnosis of BPPV can help to avoid admissions and extra imaging

Three categories: positional, horizontal, and anterior

Positional is the most common

Dizziness is not a positive indicator, a torsional nystagmus must be induced

Dix's hallpike maneuver is done to diagnose and an epley maneuver is then used for treatment

Horizontal

Usually determined to be the case if the vertigo seems positional and the dix hallpike does not work. A supine roll test would then be done to help diagnose.

Instead of a rotational nystagmus, a unilateral horizontal nystagmus is expected. The two patterns are termed geotropic and apogeotropic.