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CLINICAL DEVELOPMENTS: A PHYSICAL THERAPY RESOURCE FOR PHYSICIANS
Volume 3, No.1:
BPPV: Benign Paroxysmal Positional Vertigo
by Leanne Adell, MSPT, Physical Therapy at Dawn
How do patients with BPPV (Benign Paroxysmal Positional Vertigo) present in the clinic?
Most common vertigo provoking positions and movements include:
Incidence of BPPV:
Causes of BPPV:
What treatment will your patient receive at Physical Therapy at Dawn for BPPV?
Your patient will receive prompt, thorough, individualized, and effective treatment at Physical Therapy at Dawn.
Herdman, Susan (2007) Vestibular Rehabilitation
Hain, Timothy (2006) www.Dizziness-and-balance.com
Babac S., Arsovic N. Efficacy of Epley maneuver in treatment of benign paroxysmal positional
vertigo of the posterior semicircular canal. Vojnsosanit Pregl. 2012 Aug; 69(8): 669-74
Audiol Neurootol. 2012 Nov 6;18(2):83-88. [Epub ahead of print]
Canalith Repositioning Procedures among 965 Patients with Benign Paroxysmal Positional Vertigo.
Prokopakis E, Vlastos IM, Tsagournisakis M, Christodoulou P, Kawauchi H, Velegrakis G.
Department of Otorhinolaryngology, University of Crete School of Medicine, Heraklion, Greece.
Background: Canalith repositioning procedure (CRP) has increasingly been utilized for the last 15 years for the treatment of benign paroxysmal positional vertigo (BPPV). We assess the short- and long-term efficacy of CRP on the treatment of patients with BPPV. Methods: Nine hundred sixty-five patients (481 men and 484 women, from 18 to 87 years of age) were enrolled in this prospective study during 1995-2010. Inclusion criteria were a patient history compatible with BPPV and a positive provocative maneuver (either Dix-Hallpike or Roll test). Reported duration of symptoms at the time of their first examination varied from 1 day to 18 months. Variants of the Epley and Barbeque maneuver were used for posterior and anterior canal involvement, and horizontal canal involvement, respectively. Short-term follow-up was obtained 48 h and 7 days after initial treatment, whereas long-term follow-up was obtained at repeated 6-month intervals.
Results: Symptoms subsided immediately in 819 patients (85%) by the first CRP. Only 19 patients (2%) required CRP more than 3 times. Patients' mean follow-up was 74 months; symptom recurrence was noted in 139 patients. A statistically significantly higher recurrence rate was noted in elderly people or those with head trauma or a history of vestibular neuropathy (p < 0.001).
Conclusions: This study provides class IV evidence that CRP remains an efficient and long-lasting noninvasive treatment for BPPV, especially for younger patients without a history of head trauma or vestibular neuropathy. Elderly people have a significantly higher recurrence rate requiring additional education to minimize potential morbidity of their falls.
Copyright © 2012 S. Karger AG, Basel.
[PubMed - as supplied by publisher]
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