What is the role of re-positioning maneuvers in the treatment approaches for patients with BPPV?
Answer
Benign Paroxysmal Positional Vertigo (BPPV) is characterized by vertigo triggered by changes in head position, and it is caused by displaced crystals within the inner ear1. The primary treatment strategy involves specialized head positioning techniques known as re-positioning maneuvers2.
Re-positioning Manoeuvres
These are specific sequences of head and body movements aimed at returning displaced crystals to their appropriate location in the inner ear. This often provides immediate relief from symptoms, eliminating the need for medication in most cases3.
Over the past three years, we have successfully treated approximately 200 patients suffering from BPPV using these re-positioning maneuvers. The majority of these patients were experiencing debilitating episodes of vertigo that severely impacted their quality of life. Our clinic is equipped with a specially designed table to facilitate both the diagnosis and treatment of BPPV4.
References:
Bhattacharyya N, Gubbels SP, Schwartz SR, et al. "Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update)," Otolaryngology–Head and Neck Surgery , 2017; 156(3): 403–416. [PubMed](https://pubmed.ncbi.nlm.nih.gov/28248609/).
Hilton MP, Pinder DK. "The Epley (canalith repositioning) manoeuvre for benign paroxysmal positional vertigo" Cochrane Database of Systematic Reviews , 2014; (12): CD003162. [PubMed](https://pubmed.ncbi.nlm.nih.gov/25526741/).
Von Brevern M, Radtke A, Lezius F, et al. "Epidemiology of benign paroxysmal positional vertigo: a population based study" Journal of Neurology, Neurosurgery, and Psychiatry , 2007; 78(7): 710–715. [PubMed](https://pubmed.ncbi.nlm.nih.gov/17158831/).
Dr. Vishal Pawar is a highly skilled specialist neurologist with over a decade of experience in neurology and oto-neurology. He completed his MBBS, DNB in Medicine, and DNB in Neurology in India and has been a valuable member of the Aster Gardens specialty clinic in Dubai for seven years. Dr. Pawar's expertise lies in vestibular medicine and headache disorders, and he has actively contributed to patient care, academics, and research in these areas. He has earned recognition as a Fellow of the European Board of Neurology and has established a dedicated vertigo clinic.
Related Courses
1https://www.audiologyonline.com/audiology-ceus/course/minimum-stimulus-strategy-in-diagnosis-39433Minimum Stimulus Strategy in the Diagnosis of BPPVBenign Paroxysmal Positional Vertigo (BPPV) is the most common inner ear disorder, with a cumulative lifetime incidence of 10%. This course will cover the Minimum Stimulus Strategy (MSS), a nystagmus-based approach to streamline BPPV management, reducing the need for diagnostic and therapeutic maneuvers and minimizing patient discomfort.auditory, textual, visual
Benign Paroxysmal Positional Vertigo (BPPV) is the most common inner ear disorder, with a cumulative lifetime incidence of 10%. This course will cover the Minimum Stimulus Strategy (MSS), a nystagmus-based approach to streamline BPPV management, reducing the need for diagnostic and therapeutic maneuvers and minimizing patient discomfort.
2https://www.audiologyonline.com/audiology-ceus/course/navigating-vertigo-insights-from-dubai-39232Navigating Vertigo: Insights from DubaiEarly and accurate diagnosis is essential for providing appropriate treatment and improving patients' quality of life. Treatment approaches can range from canalith repositioning maneuvers for BPPV to lifestyle modifications and medication for conditions like Meniere's disease. This course will discuss the incidence, diagnostic approaches, spectrum of disorders, and typical symptoms clinicians must understand to provide effective care and support to individuals with vestibular disorders, ultimately enhancing their wellbeing.auditory, textual, visual
Early and accurate diagnosis is essential for providing appropriate treatment and improving patients' quality of life. Treatment approaches can range from canalith repositioning maneuvers for BPPV to lifestyle modifications and medication for conditions like Meniere's disease. This course will discuss the incidence, diagnostic approaches, spectrum of disorders, and typical symptoms clinicians must understand to provide effective care and support to individuals with vestibular disorders, ultimately enhancing their wellbeing.
3https://www.audiologyonline.com/audiology-ceus/course/seminar-in-applied-probe-microphone-38492Seminar in Applied Probe Microphone MeasurementsThis seminar will cover the scientific principles behind probe microphone measurements as applied in hearing clinics. We will briefly discuss the theory and go through how the PMM are performed in the clinic. The course is designed for audiologists seeing adult patients for hearing device prescription. Basic knowledge of PMM will be helpful.auditory, textual, visual
This seminar will cover the scientific principles behind probe microphone measurements as applied in hearing clinics. We will briefly discuss the theory and go through how the PMM are performed in the clinic. The course is designed for audiologists seeing adult patients for hearing device prescription. Basic knowledge of PMM will be helpful.
4https://www.audiologyonline.com/audiology-ceus/course/selective-canal-impairment-on-video-38493Selective Canal Impairment on Video-HIT in Peripheral Vestibular DiseasesThe introduction of modern tools assessing otolith and ampullary reflexes in the high-frequency domain (VEMPs and video-HIT, respectively) has enabled a fast functional analysis of all inner ear receptors, offering new interpretations for end-organs and afferents abnormalities detected in patients with cochleo-vestibular pathologies. The literature review highlights how vestibular disorders could result in specific lesion patterns, including selective dysfunctions involving a single receptor. A series of patients with isolated impairment of a semicircular canal at the video-HIT will be presented and discussed. Each selective canal dysfunction will be correlated to the remaining clinical-instrumental data and related inner ear pathology. The underlying hypothetical pathomechanism accounting for each single scenario will be provided, with the help of pertinent bibliographic support.auditory, textual, visual
The introduction of modern tools assessing otolith and ampullary reflexes in the high-frequency domain (VEMPs and video-HIT, respectively) has enabled a fast functional analysis of all inner ear receptors, offering new interpretations for end-organs and afferents abnormalities detected in patients with cochleo-vestibular pathologies. The literature review highlights how vestibular disorders could result in specific lesion patterns, including selective dysfunctions involving a single receptor. A series of patients with isolated impairment of a semicircular canal at the video-HIT will be presented and discussed. Each selective canal dysfunction will be correlated to the remaining clinical-instrumental data and related inner ear pathology. The underlying hypothetical pathomechanism accounting for each single scenario will be provided, with the help of pertinent bibliographic support.
5https://www.audiologyonline.com/audiology-ceus/course/vestibular-and-balance-assessment-in-36958Vestibular and Balance Assessment in Children with Sensorineural Hearing Loss: An OverviewOver the past five years, we have seen a growing interest in studying vestibular disorders in children. The most commonly noteworthy are vestibular disorders in congenital sensorineural hearing loss (SNHL) and cochlear implants. Identifying and diagnosing vestibular and balance dysfunction in children is essential for their overall well-being. However, the diagnosis process is very demanding.This talk will provide an overview of vestibular and balance assessments in children with SNHL.auditory, textual, visual
'As a primarily adult-oriented vestibular lab, this has been helpful to encourage me when to attempt testing and when to direct the parents of infants and very young children to more capable hands'Read Reviews
Over the past five years, we have seen a growing interest in studying vestibular disorders in children. The most commonly noteworthy are vestibular disorders in congenital sensorineural hearing loss (SNHL) and cochlear implants. Identifying and diagnosing vestibular and balance dysfunction in children is essential for their overall well-being. However, the diagnosis process is very demanding.This talk will provide an overview of vestibular and balance assessments in children with SNHL.
