Benign paroxysmal positional vertigo diagnostic study of choice: Difference between revisions
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{{Family tree | {{Family tree | | | | | | | | | | | A01 | | | | | | | | | | | | | | | | | | | | | | | | | | A01= Patient present with vertigo complain}} | ||
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{{Family tree | {{Family tree | | B01 | | | | | | | | | | | | | | | | B02 | | | | | | | | | | | | | | B01=Lightheadedness|B02= Spinning/motion sensation}} | ||
{{Family tree | {{Family tree | | |!| | | | | | | | | | | | | | | | | |!| | | | | | | | | | | | | | | }} | ||
{{Family tree | {{Family tree | | C01 | | | | | | | | | | | | | | | | C02 | | | | | | | | | | | | | | C01= Dizziness/false vertigo|C02=True vertigo}} | ||
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{{Family tree |boxstyle=text-align: left; | | | | | | | | | | | | | | | | | | | | | | | | E01 | | | | | | | | | | | | | | | | | | | | | | | | | | E01=sudden onset?/ Auditory symptoms?/ Horizental nystagmus?/ No neurologic symptoms?}} | {{Family tree |boxstyle=text-align: left; | | | | | | | | | | | | | | | | | | | | | | | | E01 | | | | | | | | | | | | | | | | | | | | | | | | | | E01=sudden onset?/ Auditory symptoms?/ Horizental nystagmus?/ No neurologic symptoms?}} | ||
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{{Family tree | {{Family tree | | | | | | | | | | | | | | | F01 | | | | | | | | F02 | | | | | | | | | | | | | | | | | | | | | F01=Yes|F02=No}} | ||
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{{Family tree | {{Family tree | | | | | | | | | | | | | | | H01 | | | | | | | | H02 | | | | | | | | | | | | | | | | | | | | | H01=Peripheral|H02=Central}} | ||
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{{Family tree | {{Family tree | | | | | | | | | | | | | | | G01 | | | | | | | | G02 | | | | | | | | | | | | | | | | | | | | | G01=BPPV<br>Vestibular neuritis<br>HSV oticus<br>Meniere disease<br>Labyrinthine concussion<br>Perilymphatic fistula<br>Semicircular canal dehiscence syndrome<br>Vestibular paroxysma<br>Cogan syndrome<br>Vestibular schwannoma<br>Otitis media<br>Aminoglycoside toxicity<br>Recurrent vestibulopathy|G02=Vestibular migraine<br>Epileptic vertigo<br>Multiple sclerosis<br>Brain tumors<br>Crebellar infarction/hemorrhage<br>Brain stem ischemia<br>Chiari malformation<br>Parkinson}} | ||
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Revision as of 17:36, 6 March 2019
Benign paroxysmal positional vertigo Microchapters |
Differentiating Benign Paroxysmal Positional Vertigo from other Diseases |
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Diagnosis |
Treatment |
Case Studies |
Benign paroxysmal positional vertigo diagnostic study of choice On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D.
Overview
The diagnostic study of choice for BPPV is patient history and observing nystagmus on Dix-Hall pike maneuver.
Diagnostic Study of Choice
{{#ev:youtube|https://www.youtube.com/watch?v=RNBJLed_Slc&t=4s%7C500}} |
Study of choice
The diagnostic study of choice for BPPV is patient history and observing nystagmus on Dix-Hall pike maneuver.[1][2][3]
Investigations:
- Among the patients who present with clinical signs of BPPV, the Dix-Hallpike maneuver is the most specific test for the diagnosis.
Diagnostic results
The following findings are confirmatory for BPPV:
- Recurrent brief vertigo attack which starts with certain head movements.
- Nystagmus on Dix-Hallpike maneuver.
Sequence of Diagnostic Studies
The various investigations must be performed in the following order:
If patients doesn't respond to treatment or doesn't show the typical nystagmus on Dix-Hall pike maneuver, in order to rule out other abnormalities we may perform some additional test such as:
- Electronystagmography (ENG) or video nystagmography (VNG)
- Audiometry
- Neuroimaging
For more information about these tests, click here.
Diagnostic criteria for posterial canal BPPV
Subtypes | Explanation |
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History |
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Physical exam |
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Diagnostic approach
Patient present with vertigo complain | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Lightheadedness | Spinning/motion sensation | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dizziness/false vertigo | True vertigo | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
sudden onset?/ Auditory symptoms?/ Horizental nystagmus?/ No neurologic symptoms? | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Yes | No | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Peripheral | Central | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
BPPV Vestibular neuritis HSV oticus Meniere disease Labyrinthine concussion Perilymphatic fistula Semicircular canal dehiscence syndrome Vestibular paroxysma Cogan syndrome Vestibular schwannoma Otitis media Aminoglycoside toxicity Recurrent vestibulopathy | Vestibular migraine Epileptic vertigo Multiple sclerosis Brain tumors Crebellar infarction/hemorrhage Brain stem ischemia Chiari malformation Parkinson | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
References
- ↑ Lee SH, Kim JS (June 2010). "Benign paroxysmal positional vertigo". J Clin Neurol. 6 (2): 51–63. doi:10.3988/jcn.2010.6.2.51. PMC 2895225. PMID 20607044.
- ↑ Chang MB, Bath AP, Rutka JA (October 2001). "Are all atypical positional nystagmus patterns reflective of central pathology?". J Otolaryngol. 30 (5): 280–2. PMID 11771020.
- ↑ Dorresteijn PM, Ipenburg NA, Murphy KJ, Smit M, van Vulpen JK, Wegner I, Stegeman I, Grolman W (June 2014). "Rapid Systematic Review of Normal Audiometry Results as a Predictor for Benign Paroxysmal Positional Vertigo". Otolaryngol Head Neck Surg. 150 (6): 919–24. doi:10.1177/0194599814527233. PMID 24642523.