Benign paroxysmal posicional vertigo: literature review

Abstract

Benign paroxysmal positional vertigo is the most common labyrinthine disorder caused by mechanical stimulation of vestibular receptors within the semicircular canals. It is characterized by positional vertigo and nystagmus, both caused by abrupt changes in the position of the head relative to gravity. BPPV is by far the most common cause of vertigo in adults. The cumulative lifetime incidence in the general population is around 10%. The incidence increases in those over 60 years of age and decreases exponentially below 40 years of age, being very rare in children. Women are more commonly affected than men. As for the diagnosis, it is usually clinical, obtained through an exhaustive clinical history and physical examination aimed at vestibular and neurological assessment, emphasizing some semiological maneuvers such as Dix-Hallpike and Roll Test. It is very important, given the reason for consulting dizziness/vertigo, to initially identify those circumstances that reflect significant compromise in the patient's health. A key point in the diagnosis is the differentiation between peripheral and central vertigo. The management of the pathology is basically based on two strategies: the pharmacological option, which can have an important role in the short-term control of the symptoms of the autonomic nervous system, such as nausea, paleness or vomiting. The other option corresponds to the techniques of repositioning canals or Epley maneuvers, with which, if the symptoms of vertigo are relieved, definitively in many cases.