Benign paroxysmal positional vertigo
Benign paroxysmal positional vertigo, also known as otoliths, is an extremely common form of vertigo, accounting for about 20% of all vertigo and 50% of vertigo in older patients.
It is more common in women than in men, and can be familial.
It occurs more often in the posterior canal (PC), followed by the horizontal canal (HC), and rarely in the superior canal (SC). The affected semicircular canals can be interchanged, most often after otolith repositioning maneuvers, and in a few cases, spontaneously.
Typical symptoms.
1. Paroxysmal vertigo with nystagmus is caused when the head moves rapidly to a certain position, mostly when sitting up, lying down, turning over, leaning forward or leaning back.
2. The vertigo attack lasts for a short period of time, usually a few seconds to a minute.
3. Repeatedly induced cephalad vertigo can occur repeatedly without hearing loss and vestibular dysfunction, and occasionally with tinnitus.
The diagnosis is based on:
①History of transient vertigo attacks induced by head position change, commonly when sitting up or lying down;
(2) A latency period of 5~15 seconds, nystagmus lasting no more than 30 seconds, and fatigue;
③positional test (Dix-Hallpike test or Roll-test test) is positive.
Special note: In horizontal hemianopsia, the side of the lesion should be accurately determined: 1;
Bilateral dorsal nystagmus, the side with the weaker nystagmus is the lesion side;
One side of the nystagmus is groundward and one side of the nystagmus is backward, and the groundward side is the lesion side.
Treatment.
1.Non-surgical treatment
General treatment: low-salt diet, avoiding head deviation to the affected side and strenuous head activities.
Otolith repositioning method: Posterior semicircular canal otoliths: 1. Epley otolith repositioning method 2. Semont canal stone release method (for patients with cervical spondylosis)
Horizontal semicircular canal otolithology: barbicue tumbling method
2.Surgical treatment: semicircular canal filling