Benign positional vertigo (BPV)

• disorder of one posterior semicircular canal
• a deposit on cupula or debris floating in the endolymph is sensitive to specific head rotations

Symptoms

• spells of vertigo, lasting seconds, due to sudden specific changes in head position often with mild nausea

Signs

• Hallpike Test
  • rotatory nystagmus with fast phase towards "the ear that is moved towards the floor"
  • often a latent period
  • lasts 5-15 seconds
  • with vertigo and often panic
  • reverses direction when sitting up

Cause

• degerative disorder affecting women in their 60's
• post-labyrinthitis
• post trauma -
  • head injury
  • ear surgery

Treatment

• 95% resolve usually within 2 months
• drugs are of no help
• move debris into another part of semicircular canals
• surgery
  • cut specific nerve to posterior semicircular canal
  • occlude the posterior semicircular canal