Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- positive past medical history
- recent history of head trauma or inner ear surgery
- specific provoking positions
- normal otologic exam
- brief duration of vertigo
- episodic vertigo
- severe episodes of vertigo
- sudden onset of vertigo
- nausea, imbalance, and lightheadedness
- absence of associated neurologic or otologic symptoms
- normal neurologic exam
- positive Dix-Hallpike maneuver or positive supine lateral head turn
Outros fatores diagnósticos
- age >50 years
- female sex
- positional vertigo in absence of nystagmus
Fatores de risco
- increasing age
- female sex
- head trauma
- vestibular neuronitis
- labyrinthitis
- migraines
- inner ear surgery
- Meniere disease
- otitis media
- hypertension
- hyperlipidemia
- diabetes mellitus
- vertebrobasilar insufficiency
- giant cell arteritis
- osteoporosis
- intubation
- habitual lateral head-positioning during bed rest (ipsilateral BPPV)
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- Dix-Hallpike maneuver
- supine lateral head turns
Investigações a serem consideradas
- audiogram
- brain MRI
Algoritmo de tratamento
initial presentation
multiple repositioning maneuvers and vestibular rehabilitation exercises ineffective
Colaboradores
Autores
Lorne S. Parnes, MD, FRCSC
Professor
Departments of Otolaryngology-Head and Neck Surgery and Clinical Neurological Sciences
University of Western Ontario
London
Canada
Declarações
LSP is an author of a number of references cited in this topic.
Shahin Nabi, MD, FRCSC
Departments of Otolaryngology-Head and Neck Surgery and Clinical Neurological Sciences
University of Western Ontario
London
Canada
Declarações
SN declares that he has no competing interests.
Revisores
Joel Goebel, MD, FACS
Professor and Vice Chairman
Residency Program Director
Dizziness and Balance Center Director
Otolaryngology-Head and Neck Surgery
Washington University School of Medicine
St. Louis
MO
Declarações
JG is an author of a number of references cited in this topic.
Stephen P. Cass, MD
Associate Professor
Department of Otolaryngology
University of Colorado
Aurora
CO
Declarações
SPC is an author of a number of references cited in this topic.
Steven D. Rauch, MD
Associate Professor of Otology and Laryngology
Harvard Medical School
Boston
MA
Declarações
SDR declares that he has no competing interests.
Malcolm Hilton, BA, BMBCh, FRCS (Eng), FRCS (ORL-HNS)
Consultant Otolaryngologist & Honorary Lecturer
Royal Devon & Exeter NHS Foundation Trust
Exeter
UK
Declarações
MH is the author of one reference cited in this topic.
Referências
Principais artigos
Hilton MP, Pinder DK. The Epley (canalith repositioning) manoeuvre for benign paroxysmal positional vertigo. Cochrane Database Syst Rev. 2014 Dec 8;(12):CD003162.Texto completo Resumo
Leveque M, Labrousse M, Seidermann L, et al. Surgical therapy in intractable benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg. 2007 May;136(5):693-8. Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Meniere disease
- Vestibular neuronitis
- Labyrinthitis
Mais Diagnósticos diferenciaisDiretrizes
- ACR appropriateness criteria: dizziness and ataxia
- Clinical practice guideline: benign paroxysmal positional vertigo (update)
Mais DiretrizesFolhetos informativos para os pacientes
Benign paroxysmal positional vertigo
Mais Folhetos informativos para os pacientes
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