Atypical BPPV –The Diagnosis and Treatment Modalities.

ABSTRACTDix 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