benign paroxysmal positional vertigo (redirected from Benign paroxysmal postural vertigo)

benign paroxysmal positional vertigo,

recurrent vertigo and nystagmus occurring when the head is placed in certain positions. It can be debilitating and can cause difficulty in walking straight. It is usually not associated with central nervous system lesions.

observations Patients may experience the sensation of disorientation in space combined with a sensation of motion accompanied by nystagmus, nausea and/or vomiting, perspiration, pallor, increased salivation, and general malaise. Diagnosis is made by history and clinical exam in conjunction with ENG and positional testing. Audiology, ABR, CT, or MRI may be used to rule out other causes of vertigo.

interventions Treatment is focused on a series of vestibular exercises, including gait training, sets of visual vestibular head and eye movements, Epley maneuvers, and Brandt-Daroff maneuvers. If exercises provoke nausea, premedication with antiemetics may be necessary. Surgical plugging of the posterior semicircular canal may be done in individuals with an intractable recurrent pattern of vertigo attacks that are unresponsive to exercise therapy.

nursing considerations Nursing care focuses on demonstration and return demonstration of prescribed exercises.

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benign paroxysmal positional vertigo

Cupulolithiasis Neurology A form of transient vertigo caused by utricular degeneration which liberates otoconia; otoconia drift into the lower part of the vestibule, the ampulla of the posterior semicircular canal; once there, the otoconia alter the cupola's specific gravity, changing its response characteristics from a purely angular acceleration detector to one that is stimulated by linear movements and gravity Incidence BPPV is a common form of vertigo which is more common in older adults Etiology Closed head injury, vestibular neuronitis, infections, post-stapedectomy Diagnosis History–single bouts of severe vertigo of < 1 min in duration, after a change in head position, often more severe on one side, when bending, when looking to take an object off a shelf, tilting the head back; the episodes are clustered in time and separated by remissions lasting months or more; most BPPV resolves spontaneously within several months of onset, especially following head injury; persistent, near disabling Sx may mandate surgery: singular neurectomy, vestibular neurectomy, or posterior semicircular canal occlusion