Benign Paroxysmal Positional Vertigo

Presentation

Dizziness / vertigo. Sudden onset, precipitated by changes in head position (eg rolling over in bed, turning head)
Nausea
Episodes last 10-20 seconds

Epidemiology

Most common cause of vertigo
Average age of onset is 55 years (less common in younger patients)

Examination

positive Dix-Hallpike manoeuvre

Management

BPPV has a good prognosis and usually resolves spontaneously after a few weeks to months.
Epley manoeuvre (successful in around 80% of cases)
teaching the patient exercises they can do themselves at home, for example Brandt-Daroff exercises

Pharmacological interventions include betahistine, but have varying responses

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