Atypical BPPV –The Diagnosis and Treatment Modalities.
Nilotpal Dutta*, Soumik Basu
Dix Hallpike Maneuver is performed to diagnose Benign Paroxysmal Positional Vertigo and is still relevant in the clinical evaluation of BPPV. However in clinical practice we routinely get cases of vertigo due to postural changes or head movements which donot follow the typical sign of Dix Hall pike test. These patients can be classified of being having suffering from Atypical BPPV. The Aim was to Evaluate BPPV with negative Dix Hallpike test and the treatment modality for it. Selection criteria for our studies were based on perspective clinical studies done in 64 patients with Atypical BPPV at Dept of ENT Audio-vestibular unit , in a tertiary care Hospital for a period of 1 year. Results and observations showed that 56 patients from the study group were symptomatically relieved when Epleys maneuver was performed on them consecutively for 3 days. It is seen that almost 88 % of the patients suffering from Atypical BPPV showed symptom remission when treated with Canalith Repositioning Maneuver specially the Epleys .Thus Epleys maneuver can be a treatment modality for patients suffering from BPPV without nystagmus. Patients with a typical history of positional vertigo who shows no nystagmus in Dix hallpike which we often diagnose no not a case of BPPV are actually atypical BPPVs which can be successfully treated by Epleys manoeuvre , a cheap and easy and effective way of treatment .
Keywords: BPPV, Nystagmus, Epley’s maneuver, Vertigo , Dix and Hallpike manoeuvre