Benign paroxysmal positional vertigo diagnostic study of choice: Difference between revisions
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=== Name of Diagnostic Criteria === | === Name of Diagnostic Criteria === | ||
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! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Subtypes | |||
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Explanation | |||
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! style="background: #DCDCDC; text-align: center;" |Acute Motor Axonal Neuropathy (AMAN) | |||
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* The most common type (85-90%). | |||
* Prior infection can trigger it. | |||
* [[Autoimmune disorder]]. | |||
* The target is [[schwann cell]] surface membrane or the [[myelin]]. | |||
* Causes [[demyelination]]. | |||
* In electrodiagnostic tests we can see slowing of nerve conduction. | |||
* In pathology we can see [[Lymphocyte|lymphocytic]] infiltration of peripheral nerves and [[macrophage]] invasion of [[myelin sheath]] and [[Schwann cell|schwann cells]]. | |||
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! style="background: #DCDCDC; text-align: center;" |Acute Motor Axonal Neuropathy (AMAN) | |||
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* It’s common among Chinese and Japanese people. | |||
* It can be triggered by C. jejuni. | |||
* It is associated with anti[[ganglioside]] [[antibodies]]. | |||
* [[Autoimmunity|Autoimmune]] disorder. | |||
* Target is [[Axon|axonal]] membrane. | |||
* Causes [[Axon|axonal]] degeneration in [[Motor neuron|motor neurons]]. | |||
* In electrodiagnostic study we can see reduction of compound muscle [[action potential]]. | |||
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! style="background: #DCDCDC; text-align: center;" |Acute motor and sensory axonal neuropathy | |||
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* The incidence rate is under 10%. | |||
* Causes [[Axon|axonal]] [[degeneration]]. | |||
* It is similar with [[Acute motor axonal neuropathy|AMAN]] but involves both motor and sensory [[Axon|axons]]. | |||
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! style="background: #DCDCDC; text-align: center;" |Miller Fisher syndrome | |||
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* Causes a clinical triad: [[ophthalmoplegia]], [[ataxia]] and [[areflexia]]. | |||
* Associated with [[ganglioside]] GQ1b [[antibody]]. | |||
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==References== | ==References== | ||
Revision as of 17:50, 1 March 2019
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Benign paroxysmal positional vertigo Microchapters |
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Differentiating Benign Paroxysmal Positional Vertigo from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D.
Overview
The diagnostic study of choice for BPPV is patient history and observing nystagmus on Dix-Hall pike maneuver.
Diagnostic Study of Choice
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{{#ev:youtube|https://www.youtube.com/watch?v=RNBJLed_Slc&t=4s%7C500}} |
Study of choice
The diagnostic study of choice for BPPV is patient history and observing nystagmus on Dix-Hall pike maneuver.[1][2][3]
Investigations:
- Among the patients who present with clinical signs of BPPV, the Dix-Hallpike maneuver is the most specific test for the diagnosis.
Diagnostic results
The following findings are confirmatory for BPPV:
- Recurrent brief vertigo attack which starts with certain head movements.
- Nystagmus on Dix-Hallpike maneuver.
Sequence of Diagnostic Studies
The various investigations must be performed in the following order:
If patients doesn't respond to treatment or doesn't show the typical nystagmus on Dix-Hall pike maneuver, in order to rule out other abnormalities we may perform some additional test such as:
- Electronystagmography (ENG) or video nystagmography (VNG)
- Audiometry
- Neuroimaging
For more information about these tests, click here.
Name of Diagnostic Criteria
| Subtypes | Explanation |
|---|---|
| Acute Motor Axonal Neuropathy (AMAN) |
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| Acute Motor Axonal Neuropathy (AMAN) |
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| Acute motor and sensory axonal neuropathy |
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| Miller Fisher syndrome |
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References
- ↑ Lee SH, Kim JS (June 2010). "Benign paroxysmal positional vertigo". J Clin Neurol. 6 (2): 51–63. doi:10.3988/jcn.2010.6.2.51. PMC 2895225. PMID 20607044.
- ↑ Chang MB, Bath AP, Rutka JA (October 2001). "Are all atypical positional nystagmus patterns reflective of central pathology?". J Otolaryngol. 30 (5): 280–2. PMID 11771020.
- ↑ Dorresteijn PM, Ipenburg NA, Murphy KJ, Smit M, van Vulpen JK, Wegner I, Stegeman I, Grolman W (June 2014). "Rapid Systematic Review of Normal Audiometry Results as a Predictor for Benign Paroxysmal Positional Vertigo". Otolaryngol Head Neck Surg. 150 (6): 919–24. doi:10.1177/0194599814527233. PMID 24642523.