RehabEdge homepageHost a course at your facilityCEU by topic and providerSearch for CEU by state, topic, format, etc.Comprehensive therapy products and supplies catalogRehabEdge Forum main pageReach thousands of therapists to show off your products and CEUAsk us. We're here to help.

BPPV

  		Logged in as: Guest
Users viewing this topic: none
  Printable Version
All Forums >> [RehabEdge Forum] >> Neurology >> BPPV Page: [1]
Login
Message << Older Topic   Newer Topic >>
BPPV - November 21, 2005 7:37:00 AM   
JSPT

 

Posts: 271
Joined: April 19, 2005
From: Michigan
Status: offline 		Another therapist asked me to eval her pt. she suspected of BPPV. In both testing positions, he demonstrated low amplitude horizontal nystagmus that beat to the R. He gets dizzy in all positions, so I suspect that BPPV may only be part of the puzzle.

I know that nystagmus beats to the intact side, so the L side would be involved. Does this mean that the treatment position should begin with the patient's head to the L to treat the L inner ear(using the Epley maneuver)?

_____________________________

JS
Post #: 1
Re: BPPV - November 21, 2005 5:43:00 PM   
wjPT

 

Posts: 33
Joined: October 11, 2004
From: San Diego, CA
Status: offline 		JS,

Here is a link for a good review article I used for a presentation on BPPV with illustrations of the two main repositioning manuevers (Epley and Semont) http://www.ecmaj.ca/cgi/content/full/169/7/681

Literature that I found stated that the Semont manuever may be more efficacious for the initial treatment, but if that is not effective than the Epley manuever would be more effective with repeated treatments.

warren

(in reply to JSPT)
Post #: 2
Re: BPPV - November 22, 2005 2:28:00 AM   
JSPT

 

Posts: 271
Joined: April 19, 2005
From: Michigan
Status: offline 		Thanks for the response, Warren. I didn't run across any decent articles during my search, and the one you provided is perfrect.

Thanks again!

_____________________________

JS

(in reply to JSPT)
Post #: 3
Re: BPPV - November 23, 2005 7:35:00 AM   
cej7

 

Posts: 33
Joined: August 22, 2004
Status: offline 		wjPT,
What do you mean by "both testing positions"? Dix-Hallpike & roll test, or R/L? And have other etiologies been considered or ruled out? Here is a algorithm happen to like (for starters), if your interested:

http://www-surgery.ucsd.edu/ent/DAVIDSON/Pathway/Vertigo.htm

I have also found the eMedicine summary to be good, and consistent with current literature.
http://www.emedicine.com/ent/topic761.htm

Typically, with a +Hallpike, I see a rotatory nystagmus with an increased intensity when the head is positioned towards the involved side. Just be sure to be tidy about your testing positions, so you do not impact more than one canal, or your results will be confusing.
I have great success using the Epley for cupulolithiasis, and use the Semont less frequently for canalithiasis.

My primary advice would be if you feel that it is BPPV and your treatment doesn't resolve the issue, refer to someone who routinely treats patient's with vestibular dysfunction. Here is one organization to try: http://www.vestibular.org/

btw: I am not affiliated with any of the listed organizations, however, I have just seen plenty of improperly treated patients that I have compassion for the issue :)

good luck!
~liz

(in reply to JSPT)
Post #: 4
Re: BPPV - November 23, 2005 2:16:00 PM   
ehanso

 

Posts: 353
Joined: September 14, 2004
From: Minnesota
Status: offline 		I have seen some fairly good results with the "Brandt-Daroff" positioning routine. It is easy to do and patients can do it as a home program. This has worked for me when Epley's has been marginal.

(in reply to JSPT)
Post #: 5
Re: BPPV - November 23, 2005 4:22:00 PM   
wjPT

 

Posts: 33
Joined: October 11, 2004
From: San Diego, CA
Status: offline 		Liz,

I am not sure what you are referring to? I did not state "what two testing positions" but I did state the two repositioning manuevers, the Epley or canalith repositioning manuever or the Semont or Liberatory manuever. I was not referencing any of the diagnostic manuevers.

I have also seen that algorithm in my past internet searches, and have found other algorithm in research articles I have reviewed.

warren

(in reply to JSPT)
Post #: 6
Re: BPPV - November 24, 2005 9:04:00 AM   
cej7

 

Posts: 33
Joined: August 22, 2004
Status: offline 		Warren--oops, I intended to respond to JS, not your message!! I see why you would be confused. My apologies.

~liz

(in reply to JSPT)
Post #: 7
Page:   [1]
All Forums >> [RehabEdge Forum] >> Neurology >> BPPV Page: [1]
Jump to:





New Messages No New Messages
Hot Topic w/ New Messages Hot Topic w/o New Messages
Locked w/ New Messages Locked w/o New Messages
 Post New Thread
 Reply to Message
 Post New Poll
 Submit Vote
 Delete My Own Post
 Delete My Own Thread
 Rate Posts



Google Custom Search
Forum Software © ASPPlayground.NET Advanced Edition 2.5.5 Unicode

0.078