BPPV

• Normal physiology

• Pathophysiology – a positioning vertigo

• Diagnosis – correlating disease with symptoms and signs

• Cure – The Epley Manoeuvre

• Place of drugs – none

BPPV

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Animation

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Correlate pathophysiology with symptoms

• Symptoms only occur when a particular SCC is stimulated

• The duration of an individual episode of vertigo is typical – seconds only

• Episodes come in spells

Diagnosis and Cure

• The Dix Hallpike test is diagnostic

• The Epley Manoeuvre is curative

Dix 1

Dix 2

Dix 2b

Right Ear Downwards

Characteristics of the nystagmus

• Latent period – it doesn’t start immediately

• Duration – less than a minute

• Geotropic – towards the undermost ear

• Reversed – when sitting up

• Fatigable – less severe on second test

Epley