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Classification, diagnostic criteria and management of benign paroxysmal positional vertigo.
Auris Nasus Larynx 2017; 44(1):1-6AN

Abstract

Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vertigo and the posterior and/or lateral semicircular canals are usually affected. BPPV is characterized by brief attacks of rotatory vertigo associated with positional and/or positioning nystagmus, which are elicited by specific head positions or changes in head position relative to gravity. In patients with the posterior-canal-type of BPPV, torsional nystagmus is induced by the Dix-Hallpike maneuver. In patients with the lateral-canal-type of BPPV, horizontal geotropic or apogeotropic nystagmus is induced by the supine roll test. The pathophysiology of BPPV is canalolithiasis comprising free-floating otoconial debris within the endolymph of a semicircular canal, or cupulolithiasis comprising otoconial debris adherent to the cupula. The observation of positional and/or positioning nystagmus is essential for the diagnosis of BPPV. BPPV is treated with the canalith repositioning procedure (CRP). Through a series of head position changes, the CRP moves otoconial debris from the affected semicircular canal to the utricle. In this review, we provide the classification, diagnostic criteria, and examinations for the diagnosis, and specific and non-specific treatments of BPPV in accordance with the Japanese practical guidelines on BPPV published by the Japan Society for Equilibrium Research.

Authors+Show Affiliations

Department of Otorhinolaryngology - Head and Neck Surgery, Osaka University Graduate School of Medicine, Osaka 565-0871, Japan. Electronic address: timai@ent.med.osaka-u.ac.jp.Department of Otolaryngology, University of Tokushima School of Medicine, Tokushima 770-8503, Japan.Department of Otolaryngology, Saitama Medical University Hospital, Saitama 350-0495, Japan.Shigeno Otolaryngology Vertigo-Hearing Impairment Clinic, Nagasaki 852-8132, Japan.Department of Otorhinolaryngology - Head and Neck Surgery, University of Toyama, Toyama 930-0194, Japan.Ohsawano Rehabilitation Facility for the Elderly Kagayaki, Toyama 939-2224, Japan.Department of Otolaryngology, Tokyo Medical University Hospital, Tokyo 160-0023, Japan.No affiliation info available

Pub Type(s)

Journal Article
Practice Guideline
Review

Language

eng

PubMed ID

27174206

Citation

Imai, Takao, et al. "Classification, Diagnostic Criteria and Management of Benign Paroxysmal Positional Vertigo." Auris, Nasus, Larynx, vol. 44, no. 1, 2017, pp. 1-6.
Imai T, Takeda N, Ikezono T, et al. Classification, diagnostic criteria and management of benign paroxysmal positional vertigo. Auris Nasus Larynx. 2017;44(1):1-6.
Imai, T., Takeda, N., Ikezono, T., Shigeno, K., Asai, M., Watanabe, Y., & Suzuki, M. (2017). Classification, diagnostic criteria and management of benign paroxysmal positional vertigo. Auris, Nasus, Larynx, 44(1), pp. 1-6. doi:10.1016/j.anl.2016.03.013.
Imai T, et al. Classification, Diagnostic Criteria and Management of Benign Paroxysmal Positional Vertigo. Auris Nasus Larynx. 2017;44(1):1-6. PubMed PMID: 27174206.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Classification, diagnostic criteria and management of benign paroxysmal positional vertigo. AU - Imai,Takao, AU - Takeda,Noriaki, AU - Ikezono,Tetsuo, AU - Shigeno,Kohichiro, AU - Asai,Masatsugu, AU - Watanabe,Yukio, AU - Suzuki,Mamoru, AU - ,, Y1 - 2016/05/09/ PY - 2016/01/02/received PY - 2016/03/19/revised PY - 2016/03/28/accepted PY - 2016/5/14/pubmed PY - 2017/3/7/medline PY - 2016/5/14/entrez KW - Benign paroxysmal positional vertigo KW - Canalith repositioning procedure KW - Canalolithiasis KW - Cupulolithiasis SP - 1 EP - 6 JF - Auris, nasus, larynx JO - Auris Nasus Larynx VL - 44 IS - 1 N2 - Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vertigo and the posterior and/or lateral semicircular canals are usually affected. BPPV is characterized by brief attacks of rotatory vertigo associated with positional and/or positioning nystagmus, which are elicited by specific head positions or changes in head position relative to gravity. In patients with the posterior-canal-type of BPPV, torsional nystagmus is induced by the Dix-Hallpike maneuver. In patients with the lateral-canal-type of BPPV, horizontal geotropic or apogeotropic nystagmus is induced by the supine roll test. The pathophysiology of BPPV is canalolithiasis comprising free-floating otoconial debris within the endolymph of a semicircular canal, or cupulolithiasis comprising otoconial debris adherent to the cupula. The observation of positional and/or positioning nystagmus is essential for the diagnosis of BPPV. BPPV is treated with the canalith repositioning procedure (CRP). Through a series of head position changes, the CRP moves otoconial debris from the affected semicircular canal to the utricle. In this review, we provide the classification, diagnostic criteria, and examinations for the diagnosis, and specific and non-specific treatments of BPPV in accordance with the Japanese practical guidelines on BPPV published by the Japan Society for Equilibrium Research. SN - 1879-1476 UR - https://www.unboundmedicine.com/medline/citation/27174206/Classification_diagnostic_criteria_and_management_of_benign_paroxysmal_positional_vertigo_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0385-8146(16)30107-9 DB - PRIME DP - Unbound Medicine ER -