Post by Master Kim on Mar 15, 2015 18:16:10 GMT -5
Benign paroxysmal positional vertigo (BPPV) is a disorder arising in the inner ear. Its symptoms are repeated episodes of positional vertigo, that is, of a spinning sensation caused by changes in the position of the head. BPPV is the most common cause of the symptoms of vertigo.
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Signs and symptoms
Symptoms
- Vertigo: Spinning dizziness, which must have a rotational component.
- Short duration (paroxysmal): Lasts only seconds to minutes
- Positional in onset: Can only be induced by a change in position.
- Nausea is often associated
- Visual disturbance: It may be difficult to read or see during an attack due to associated nystagmus.
- Pre-syncope (feeling faint) or syncope (fainting) is unusual.
- Emesis (vomiting) is uncommon, but possible.
Many patients will report a history of vertigo as a result of fast head movements. Many patients are also capable of describing the exact head movements that provoke their vertigo.
- Rotatory (torsional) nystagmus, where the top of the eye rotates towards the affected ear in a beating or twitching fashion, which has a latency and can be fatigued (the vertigo should lessen with deliberate repetition of the provoking maneuver).
- Nystagmus should only last for 30 seconds to one minute.
Purely horizontal nystagmus and symptoms of vertigo lasting more than one minute can also indicate BPPV occurring in the horizontal semicircular canal.
Patients do not experience other neurological deficits such as numbness or weakness, and if these symptoms are present, a more serious etiology such as posterior circulation stroke or ischemia, must be considered.
The spinning sensation experienced from BPPV is usually triggered by movement of the head, will have a sudden onset, and can last anywhere from a few seconds to several minutes. The most common movements patients report triggering a spinning sensation are tilting their head upwards in order to look at something, and rolling over in bed.
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