benign paroxysmal positional vertigo


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Related to benign paroxysmal positional vertigo: Meniere's disease, Epley maneuver

vertigo

 [ver´tĭ-go]
a sensation of rotation or movement of one's self (subjective vertigo) or of one's surroundings (objective vertigo) in any plane. The term is sometimes used erroneously as a synonym for dizziness. Vertigo may result from diseases of the inner ear or may be due to disturbances of the vestibular centers or pathways in the central nervous system.
benign paroxysmal positional vertigo recurrent vertigo and nystagmus occurring when the head is placed in certain positions, usually not associated with lesions of the central nervous system.
benign positional vertigo (benign postural vertigo) benign paroxysmal positional vertigo.
central vertigo that due to disorder of the central nervous system.
cerebral vertigo vertigo resulting from a brain lesion, such as in meningogenic labyrinthitis. Called also organic vertigo.
disabling positional vertigo constant vertigo or dysequilibrium and nausea in the upright position, without hearing disturbance or loss of vestibular function.
labyrinthine vertigo Meniere's disease.
organic vertigo cerebral vertigo.
peripheral vertigo vestibular vertigo.
positional vertigo that associated with a specific position of the head in space or with changes in position of the head in space.
vestibular vertigo vertigo due to disturbances of the vestibular centers or pathways in the central nervous system.

be·nign par·ox·ys·mal positional ver·ti·go

a recurrent, brief form of positional vertigo occurring in clusters; believed to result from displaced remnants of utricular otoconia into the semicircular ducts, usually the posterior.

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.

benign paroxysmal positional vertigo

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, more common in older adults.
 
Aetiology
Closed head injury, vestibular neuronitis, infections, post-stapedectomy.
 
Diagnosis
History—e.g., single bouts of severe vertigo of < 1 min in duration after a change in head position, often more severe on one side, when bending, looking to take an object off a shelf or tilting the head back; the episodes are clustered in time and separated by remissions lasting months or more; Hallpike maneuver.
 
Management
Particle repositioning maneuver; occlusion of affected canal using a bone chop:fibrinogen glue plug; most BPPV resolves spontaneously within several months of onset, especially following head injury; persistent, near-disabling symptoms may mandate surgery: singular neurectomy, vestibular neurectomy or posterior semicircular canal occlusion.

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

be·nign par·ox·ys·mal po·si·tion·al ver·ti·go

(bĕ-nīn' păr-ok-siz'măl pŏ-zish'ŭn-ăl vĕr'ti-gō)
A recurrent, brief form of positional vertigo occurring in clusters; believed to result from displaced remnants of utricular otoconia.

benign paroxysmal positional vertigo

A very common cause of dizziness precipitated by head movements or by lying down or turning over in bed. There is a typical circular movement of the eyes (rotational nystagmus) when the head is inclined and turned to the affected side. The disorder is due to debris in the semicircular canals that moves with head movement causing a current of endolymph and stimulation of the position sense mechanism. In nearly 80 per cent of cases the condition resolves spontaneously in a few days or weeks. The condition can be corrected by a sequence of movements of the head and truck that rotates the posterior semicircular canal in a plane so that debris is moved into the utricle (Epley manoeuvre).
References in periodicals archive ?
Halker RB, Barrs DM, Wellik KE, Wingerchuk DM and Demaerschalk BM (2008): Establishing a diagnosis of benign paroxysmal positional vertigo through the dix-hallpike and side-lying maneuvers: a critically appraised topic.
Norre ME (1995): Reliability of examination data in the diagnosis of benign paroxysmal positional vertigo.
Oghalai JS, Manolidis S, Barth JL, Stewart MG and Jenkins HA (2000): Unrecognized benign paroxysmal positional vertigo in elderly patients.
Posterior semicircular canal occlusion for intractable benign paroxysmal positional vertigo.
Non-ampullary plugging of the posterior semicircular canal for benign paroxysmal positional vertigo.
Unexpected complication of posterior canal occlusion surgery for benign paroxysmal positional vertigo.
Effectiveness of the particle repositioning maneuver in subtypes of benign paroxysmal positional vertigo.
The author conducted a retrospective study to determine the prevalence of a falling sensation in patients who underwent the Epley canalith repositioning maneuver for the treatment of benign paroxysmal positional vertigo.
Two mechanisms have been proposed to explain the cause of benign paroxysmal positional vertigo (BPPV): cupulolithiasis (1) and canalithiasis.
Ablation of posterior semicircular canal for benign paroxysmal positional vertigo.
Diagnostic problems in patients with benign paroxysmal positional vertigo.
A review of management of benign paroxysmal positional vertigo by exercise therapy and by repositioning manoeuvres.

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