Benign paroxysmal dizziness

Benign paroxysmal positional dizziness is paroxysmal vestibular dizziness, the provoking factor of which is the change in the position of the head and body.

ICD-10 code

Benign paroxysmal dizziness.

Epidemiology of benign paroxysmal dizziness

The frequency of benign paroxysmal positional vertigo is different and amounts to, but to a number of authors, 3-50% of all patients with peripheral vestibular vertigo. Women suffer from this disease more often than men.

Classification of benign paroxysmal dizziness

Benign paroxysmal positional vertigo is primarily classified by reason of the occurrence: idiopathic or other (post-traumatic, post-infection, etc.). Depending on the location of the free-moving particles of the otolith membrane in relation to the structures of the semicircular canal, the most frequent forms of benign paroxysmal positional dizziness are distinguished:

• cupulolithiasis - the particles are fixed on the cupula of one of the channels of the vestibular receptor;
• canalolithiasis - the macula particles are located freely in the cavity of the canal.

Causes of benign paroxysmal dizziness

In 50-75% of all cases, the cause can not be established and therefore it is an idiopathic form. Possible cause of benign paroxysmal positional dizziness can be: trauma, labyrinthitis, Meniere's disease, surgical operations (both general and otologic).

Benign paroxysmal dizziness - Causes and pathogenesis

Symptoms of benign paroxysmal dizziness

A clinical picture of benign paroxysmal positional vertigo is characterized by the presence of sudden vestibular vertigo (with a feeling of rotation of objects around the patient) when the position of the head and body changes. Most often, dizziness occurs in the morning after sleep or at night when you turn in the bed. Dizziness is characterized by high intensity and lasts no more than one minute. If the patient returned to the initial position at the time of dizziness, the dizziness stops faster. Also provocative movements can be tilting the head back and tilting down, so most patients, experimentally determined this effect, try to make turns, rises from the bed and head inclinations slowly and do not use the plane of the affected canal.

Benign paroxysmal dizziness - Symptoms

Diagnosis of benign paroxysmal dizziness

In benign paroxysmal positional dizziness, anamnesis does not provide exhaustive information for establishing a diagnosis. It is more important to conduct a survey of a patient with a neurologist or an otoneurologist using a standard protocol. Specific tests for establishing benign paroxysmal positional dizziness are positional tests of Dix-Hallpike, Brandt-Daroff, and others.

The Dix-Holggike positional test is performed as follows: the patient sits on the couch and turns his head to 45 degrees. Right or left. Then the doctor, fixing the patient's head with his hands, quickly moves it to the position lying on the back, while the patient's head hangs over the edge of the couch and is in a relaxed state, held by the doctor's hands. The doctor observes the movements of the patient's eyes and asks about the occurrence of dizziness. It is necessary to warn the patient in advance about the possibility of appearance of a typical dizziness and convince in reversibility and safety of this condition. The nystagmus typical for benign paroxysmal positional vertigo is necessarily latent, which is associated with some delay in the movement of the clot in the plane of the canal or deviation of the cupula when the head is tilted. Since the particles have a certain mass and move under the action of gravity in a fluid with a certain viscosity, there is a short period of set the settling rate.

Benign paroxysmal dizziness - Diagnosis

Treatment of benign paroxysmal dizziness

Of the exercises, more often recommended to patients for self-fulfillment, it should be noted the method of the Brandt-Daroff. According to this technique, the patient is recommended to perform exercises three times a day for five inclines in both directions in one session. If there is dizziness at least once in the morning in any position, the exercises are repeated day and night. To perform the procedure, the patient needs to sit down in the center of the bed after waking up, dangling his legs down. Then it is laid on any side with a 45 ° turned head to the top and is in this position for 30 seconds (or until dizziness ends). After this, the patient rises to the starting position "sitting", in which arrives 30 s. Then quickly stacked on the opposite side with a head turn upward by 45 ^e. After 30 seconds, returns to the starting position "sitting." In the morning the patient makes five repeated inclinations in both directions. If dizziness has arisen at least once in any position, the slopes must be repeated in the afternoon and evening.

Benign paroxysmal dizziness - Treatment

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