BPPV & The Epley Maneouvre / Maneuver

VERTIGO & The Epley Manoeuvre Dr Colin Mitchell SpR Geriatrics / GIM MSc Geriatric Medicine (Special Senses Module)

Objectives ,[object Object],[object Object],[object Object],[object Object]

Vertigo ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Vertigo ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Peripheral Central

Peripheral vs Central ,[object Object],Peripheral Central Abrupt onset Intense Nausea / Vomiting Auditory complaints Associated with head position Usually more gradual onset Often less intense Less so Less often Constant / Non-positional

Peripheral vs Central ,[object Object],Peripheral Central Nystagmus - delayed, fatiguable (Torsional nystagmus) Auditory disturbance Nystagmus - immediate, non-fatiguable (Vertical nystagmus) Other CN2-12 signs Other PNS signs esp ataxia

Causes of Vertigo ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

“ Benign” Paroxysmal Positional Vertigo

BPPV ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

BPPV Pathophysiology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Hallpike Test ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

The Epley Manoeuvre ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

The Epley ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

The Epley Video by Dr P Hain – see credits for attribution and web link

Evidence for Epley ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Cochrane Review ,[object Object]

Non-specialists ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Other Treatments ,[object Object],[object Object],[object Object],[object Object],[object Object]

Summary ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

References ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

BPPV & The Epley Maneouvre / Maneuver

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BPPV & The Epley Maneouvre / Maneuver