Benign Paroxysmal Positional Vertigo (BPPV) History, Pathophysiology, Office Treatment and Future Directions英文文献资料.docVIP

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Benign Paroxysmal Positional Vertigo (BPPV) History, Pathophysiology, Office Treatment and Future Directions英文文献资料.doc

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Benign Paroxysmal Positional Vertigo (BPPV) History, Pathophysiology, Office Treatment and Future Directions英文文献资料

HindawiPublishingCorporation InternationalJournalofOtolaryngology Volume2011,ArticleID835671,13pages doi:10.1155/2011/835671 ReviewArticle BenignParoxysmalPositionalVertigo(BPPV):History, Pathophysiology,Of?ceTreatmentandFutureDirections JeremyHornibrook DepartmentofOtolaryngology,HeadandNeckSurgery,ChristchurchHospital,2RiccartonAvenue,Christchurch8011,NewZealand CorrespondenceshouldbeaddressedtoJeremyHornibrook,jeremy@ Received12March2011;Accepted18May2011 AcademicEditor:BillGibson Copyright?2011JeremyHornibrook.ThisisanopenaccessarticledistributedundertheCreativeCommonsAttributionLicense, whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperlycited. BPPV is the most common cause of vertigo. It most often occurs spontaneously in the 50 to 70 year age group. In younger individualsitisthecommonestcauseofvertigofollowingheadinjury.Thereisawidespectrumofseverityfrominconsistent positionalvertigotocontinuousvertigoprovokedbyanyheadmovement.Itislikelytobeacauseoffallsandothermorbidityin theelderly.Misdiagnosiscanresultinunnecessarytests.Thecardinalfeaturesandadiagnostictestwereclari?edin1952byDixand Hallpike.Subsequently,ithasbeenestablishedthatthesymptomsareattributabletodetachedotoconiainanyofthesemicircular canals.BPPVsymptomscanresolvespontaneouslybutcanlastfordays,weeks,months,andyears.Unusualpatternsofnystagmus andnonrepsonsetotreatmentmaysuggestcentralpathology.Diagnosticstrategiesandthesimplest“o?ce”treatmenttechniques aredescribed.Futuredirectionsforresearcharediscussed. 1.HistoryandPathophysiology “...thereappearedastrongrotatorynystagmustotheright withaverticalcomponentupwards,whichwhenlookingto therightwaspurelyrotatory,andwhenlookingtotheleft waspurelyvertical.”In1952MargaretDix(1911–1981)and CharlesHallpike(1900–1979)[4]atQueenSquareHospi- tal, based on 100 patients, presented a symptomatological de?nition and a provocative positional test for what they called“positionalnystagmusofthebenignpositionaltype.” Fo