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Benign Paroxysmal Positioning Vertigo (BPPV)

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Vertigo: Its Multisensory Syndromes

Part of the book series: Clinical Medicine and the Nervous System ((CLIN.MED.NERV.))

Abstract

Benign paroxysmal positional vertigo (preferably described as positioning vertigo) was initially described by Bárány in 1921, and the term was coined by Dix and Hallpike (1952). In this condition brief attacks of rotational vertigo and concomitant positioning rotary-linear nystagmus are precipitated by rapid head extension and by lateral head tilt towards the affected ear (Fig. 11.1). Cupulolithiasis of the posterior semicircular canal is responsible (Schuknecht 1969), and the condition is the most common cause of vertigo in the elderly. Spontaneous recovery is common, but there is also a high effective form of mechanical therapy which involves the use of positioning manoeuvres applied serially (Brandt and Daroff 1980).

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References

  • Baloh RW, Sakala SM, Honrubia V (1979) Benign paroxysmal positional nystagmus. Am J Otolaryng 1:1–5

    Article  CAS  Google Scholar 

  • Baloh RW, Honrubia V, Jacobson K (1987) Benign positional vertigo. Neurol 37:371–378

    CAS  Google Scholar 

  • Barber HO (1964) Positional nystagmus especially after head injury. Laryngoscope 73:891–944

    Google Scholar 

  • Barany R (1921) Diagnose von Krankheitserscheinungen im Bereiche des Otolithenapparates. Acta Otolaryngol (Stockh) 2:434–437

    Article  Google Scholar 

  • Black FO, Nashner LM (1984) Vestibulo-spinal control differs in patients with reduced versus distorted vestibular function. Acta Otolaryngol (Stockh) suppl 406:110–114

    CAS  Google Scholar 

  • Black FO, Wall III C, Nashner LM (1983) Effects of visual and support surface orientation references upon postural control in vestibular deficient subjects. Acta Otolaryngol (Stockh) 95:199–210

    Article  CAS  Google Scholar 

  • Brandt Th (1986) Vertigo and dizziness. In: Asbury AK, McKhann GM, McDonald I (eds) Diseases of the nervous system. Saunders, Philadelphia, pp 561–576

    Google Scholar 

  • Brandt Th, Daroff RB (1980) Physical therapy for benign paroxysmal positional vertigo. Arch Otolaryngol 106:484–485

    Article  PubMed  CAS  Google Scholar 

  • Büchele W, Brandt Th (1979) Vestibulo-spinal ataxia in benign paroxysmal positional vertigo. Agressologie 20:221–222

    Google Scholar 

  • Büchele W, Brandt Th (1986) Benign paroxysmal positional vertigo and posture. In: Bles W, Brandt Th (eds) Disorders of posture and gait. Elsevier, Amsterdam, pp 141–156

    Google Scholar 

  • Büchele W, Brandt Th (1988) Vestibular neuritis-a horizontal semicircular canal paresis? Adv Oto-Rhino-Laryng 42:157–161

    Google Scholar 

  • Cohen B, Tokumasu K, Goto K (1966) Semicircular canal nerve, eye and head movements: the effect of changes in initial eye and head position on the plane of the induced movement. Arch Ophthal (Chicago) 76:523–531

    Article  CAS  Google Scholar 

  • Dichgans J, Mauritz KH, Allum JHJ, Brandt Th (1975) Postural sway in normals and atactic patients: analysis of the stabilizing and destabilizing effects of vision. Agressologie 17C: 15–24

    Google Scholar 

  • Dix R, Hallpike CS (1952) The pathology, symptomatology and diagnosis of certain common disorders of the vestibular system. Ann Otol Rhinol Laryngol 6:987–1016

    Google Scholar 

  • Epley JM (1980) New dimensions of benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg 88:599–605

    PubMed  CAS  Google Scholar 

  • Fluur E (1974) Positional and positioning nystagmus as a result of utriculo-cupular integration. Acta Otolaryngol (Stockh) 78:19–27

    Article  CAS  Google Scholar 

  • Gacek RR (1978) Further observations on posterior ampullary nerve transection for positional vertigo. Ann Otol Rhinol Laryngol 87:300–306

    PubMed  CAS  Google Scholar 

  • Gacek RR (1984) Cupulolithiasis and posterior ampullary nerve transection. Ann Otol Rhinol Laryngol, Suppl 112, 93:25–29

    CAS  Google Scholar 

  • Gordon N (1954) Post-traumatic vertigo, with special reference to positional nystagmus. Lancet i:1216–1218

    Article  Google Scholar 

  • Graf W, Ezure K (1986) Morphology of vertical canal related second order vestibular neurons in the cat. Exp Brain Res 63:35–48

    Article  PubMed  CAS  Google Scholar 

  • Graf W, McCrea RA, Baker R (1983) Morphology of posterior canal-related secondary vestibular neurons in rabbit and cat. Exp Brain Res 52:125–138

    Article  PubMed  CAS  Google Scholar 

  • Gussen R (1980) Saccule otoconia displacement into cochlea in cochleosaccular degeneration. Arch Otolaryngol 106:161–166

    Article  PubMed  CAS  Google Scholar 

  • Harbert F (1970) Benign paroxysmal positional nystagmus. Arch Opthal 84:298–302

    Article  CAS  Google Scholar 

  • Hasegawa T (1933) Die Veränderung der labyrinthären Reflexe bei zentrifugierten Meerschweinchen. Pflügers Arch Ges Physiol 232:454–465

    Article  Google Scholar 

  • Igarashi M, Nagaba M (1968) Vestibular end-organ damage in squirrel monkeys after exposure to intensive linear acceleration. In: Third symposium on the role of the vestibular organs in space exploration, NASA SP-152, 63–61

    Google Scholar 

  • Johnson L-G, Hawkins JE (1972) Sensory and neural degeneration with aging, as seen in microdissections of the human inner ear. Ann Otol 81:179–193

    Google Scholar 

  • Katsarkas A (1987) Nystagmus of paroxysmal positional vertigo: some new insights. Ann Otol Rhinol Laryngol 96:305–308

    PubMed  CAS  Google Scholar 

  • Katsarkas A, Kirkham Th (1978) Paroxysmal positional vertigo. A study of 255 cases. J Otolaryngol 7:320–330

    PubMed  CAS  Google Scholar 

  • Katsarkas A, Outerbridge JS (1983) Nystagmus of paroxysmal positional vertigo. Ann Otol Rhinol Laryngol 92:146–150

    PubMed  CAS  Google Scholar 

  • Lindsay JR, Hemenway WG (1956) Postural vertigo due to unilateral sudden partial loss of vestibular function. Ann Otol Rhinol Laryngol 65:692–708

    PubMed  Google Scholar 

  • Longridge NS, Barber HO (1978) Bilateral paroxysmal positioning nystagmus. Canad J Otol 7:395–400

    CAS  Google Scholar 

  • Markham CH, Diamond SG, Juichi I (1987) Utricular dysfunction in benign paroxysmal positional vertigo. In: Graham MD, Kemink L (eds) The vestibular system: neurophysiologic and clinical research. Raven Press, New York, pp 275–283

    Google Scholar 

  • McClure JA (1985) Horizontal canal BPV. J Otolaryngol 14:30–35

    PubMed  CAS  Google Scholar 

  • McClure JA (1988) Functional basis for horizontal canal BPV. In: Barber HO, Sharpe JA (eds) Vestibular disorders. Year Book Medical Publishers, Chicago, pp 233–238

    Google Scholar 

  • Morgenstern D, Farrenkopf J (1980) Die Funktion des hinteren vertikalen Bogenganges beim Menschen. Arch Otorhinolaryng 227:482

    Article  Google Scholar 

  • Rietz R, Troia BW, Yonkers AJ, Norris TW (1987) Glycerol-induced positional nystagmus in human beings. Otolaryngol Head Neck Surg 97:282–287

    PubMed  CAS  Google Scholar 

  • Schmidt CL (1985) Zur Pathophysiologic des peripheren, paroxysmalen, benignen Lagerungsschwindel (BPPV). Laryng Rhinol Otol 64:146–155

    Article  CAS  Google Scholar 

  • Schuknecht HF (1962) Positional vertigo. Clinical and experimental observations. Trans Am Acad Ophthal Otolaryng 66:319–331

    CAS  Google Scholar 

  • Schuknecht HF (1969) Cupulolithiasis. Arch Otolaryngol 90:765–778

    Article  PubMed  CAS  Google Scholar 

  • Schuknecht HF, Ruby RRF (1973) Cupulolithiasis. Adv Oto-Rhino-Laryng 22:434–443

    Google Scholar 

  • Szentágothai I (1950) The elementary vestíbulo ocular reflex arc. J Neurophysiol 13:395–407

    PubMed  Google Scholar 

  • Vyslonzil E (1963) Über eine umschriebene Ansammlung von Otokonien in hinteren häutigen Bogengängen. Monatschr Ohrenheilkd 97:63

    CAS  Google Scholar 

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© 1991 Springer-Verlag London Limited

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Brandt, T. (1991). Benign Paroxysmal Positioning Vertigo (BPPV). In: Vertigo: Its Multisensory Syndromes. Clinical Medicine and the Nervous System. Springer, London. https://doi.org/10.1007/978-1-4471-3342-1_11

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  • DOI: https://doi.org/10.1007/978-1-4471-3342-1_11

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-3344-5

  • Online ISBN: 978-1-4471-3342-1

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