Benign Paroxysmal Positional Vertigo: Rehabilitation
摘要
Benign paroxysmal positional vertigo (BPPV) is the most common disorder among peripheral causes related to vestibular end-organ dysfunction. Vertigo, accompanied by characteristic nystagmus, is sudden and transient. BPPV has been reported in 17–42% of patients presenting with dizziness, making it the most frequent cause of vertigo. The most commonly encountered type is posterior semicircular canal BPPV, accounting for approximately 85–95% of all cases. The clinical picture is caused by calcium carbonate crystals detaching from the utricular macula and falling into any of the semicircular canals. The movements most likely to trigger vertigo include the patient getting in and out of bed, moving and turning their head up and down, standing up from a sitting position, and turning in bed. The Dix-Hallpike test is performed to detect involvement of the posterior semicircular canal. The most frequently used maneuvers in treatment are Epley’s modified particle repositioning and Semont’s liberatory maneuvers. The barbecue (Lempert) and Gufoni maneuvers are treatment methods applied in horizontal canal BPPV. In addition to maneuvers, vestibular exercise exercises named Brandt-Daroff, Cawthorne, Norre, and Beckers are important in BPPV treatment. However, exercises are not effective in preventing recurrences.