Atypical BPPV –The Diagnosis and Treatment Modalities.
Nilotpal Dutta*, Soumik Basu
ABSTRACT
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