(Benign position dizziness, benign positional vertigo; BPLS)
Benign paroxysmal positional vertigo certain head positions call short-term (<60 s) dizziness forth. It develop nausea and nystagmus. The diagnosis is made clinically. Treatment consists of otolith Repositionierungsmanöver. If any, medication or surgical therapy is rarely indicated.
Benign paroxysmal positional vertigo (BPPV) is the most common cause of recurrent otogenem vertigo. The attacks occur more frequently with age and can affect the sense of balance of older people so that they become increasingly vulnerable to injury rich falls.
Benign paroxysmal positional vertigo certain head positions call short-term (<60 s) dizziness forth. It develop nausea and nystagmus. The diagnosis is made clinically. Treatment consists of otolith Repositionierungsmanöver. If any, medication or surgical therapy is rarely indicated. Benign paroxysmal positional vertigo (BPPV) is the most common cause of recurrent otogenem vertigo. The attacks occur more frequently with age and can affect the sense of balance of older people so that they become increasingly vulnerable to injury rich falls. As a cause of the fault is suspected etiology a shift from Statokonien (which is usually embedded in the saccule and utricle Kalziumcarbonatkristalle). The displaced material can simulate movement when it stimulates hair cells most frequently in the posterior semicircular canal (and rarely in the upper archway). Among the etiological factors include spontaneous degeneration of tubular otolith membranes Labyrinthine concussion otitis media ear surgery Recent viral infection (eg., Viral neuronitis) head trauma Longer anesthesia or bed rest Past vestibular disorders (eg. As Meniere's disease) occlusion of the anterior vestibular artery symptoms and complaints of dizziness caused by head movement is triggered (eg. as if the patient turns over in bed or bends over to pick something up). An acute attack of vertigo takes only seconds to minutes; after the morning peak incidence of the episodes can during the day. While it may cause nausea and vomiting, but there occur neither hearing nor on tinnitus. Diagnosis Clinical evaluation gadolinium-enhanced MRI in suspected CNS lesion The diagnosis of benign positional vertigo is based on the typical symptoms and the Dix-Hallpike maneuver (provocation test for positional nystagmus; nystagmus) detectable nystagmus in the absence of other neurological findings. Patients with BPPV do not need to be further investigated. When a nystagmus suggests suspicion of a CNS lesion, a gadolinium-enhanced MRI is performed. Unlike the positional nystagmus in BPPV shows a positional nystagmus in CNS lesions neither latency nor mitigation; He also solves no similarly strong subjective (rotary) sensation in the patient and can last as long as they maintain that position. In CNS lesions, a vertical nystagmus or a nystagmus with alternating direction may occur, which can rotate as a rotary nystagmus also contrary to the expected direction. Provocative therapy maneuvers fatigue otolith-reduction maneuver Drug treatment is usually not recommended usually sounds a BPPV within weeks or months of spontaneous, but it can also remain for months or years. Since it may be a longer-lasting disorder (as in Meniere's disease) is not recommended drug treatment. Often, the imbalance worsened even further by drug side effects. As a BPPV exhausted, provides a treatment approach that patients perform the same in the morning in an area protected from certain provocative maneuvers to reduce the symptoms for the rest of the day. Otolith-reduction maneuver (by Epley and Semont) serve to provide return stray otolith by a specific sequence of movements of the head back in the utricle. Following such a maneuver, the patient should a few minutes to sit upright or lie half raised. Both maneuvers can be repeated if necessary. The Epley maneuver. This maneuver is used to treat benign paroxysmal positional vertigo by stray otoliths be transported from the posterior semi-circular canal back into the utricle. If dizziness occurs during one of the positions, this position is maintained until the dizziness subsides. For the Semont maneuver the patient is sitting upright in the middle of a treatment couch and turns his head over to the side of the unaffected ear; this head position is maintained throughout the maneuver. Next, the upper body is thus lowered to the lying sideways, that the data page is at the bottom and the nose points upwards. he is after 3 min raised from this situation quickly, but without straight to direct the head again, and so supported on the other side, that the nose shows this time down. After 3 minutes in this position, the patient is allowed to slowly raise and turn his head back to the normal position. Important points dizziness occurs because of the relocation of Statokonien in an archway; the symptoms are triggered by head movements. Nausea and vomiting are usually present, but no tinnitus or hearing loss. The diagnosis is made clinically, but some patients may need an MRI to rule out other diseases. Treatment consists of otolith Repositionierungsmanöver. Drugs rarely help and can aggravate symptoms.