Vertigo: Diagnosis and Management
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Expires December 31, 2014
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Benign paroxysmal positional vertigo accounts for approximately 42% of cases of vertigo seen in primary care settings and is the single most common cause of vertigo in the United States. Our expert outlines an evidence-based approach to diagnosis, which results in an increase in desirable patient outcomes and a decrease in unnecessary tests and medications.
CONCLUSION
BPPV is a common disorder that presents most often in the primary care setting. However, most dizzy patients never see a specialist or clinician who is skilled in providing vestibular evaluation and treatment. To avoid missing the diagnosis or ordering unnecessary diagnostic and laboratory tests, clinicians can readily perform the Dix-Hallpike test and CRP in the office on patients with suspected BPPV.
CRP and vestibular rehabilitation have been proven effective in treating chronic disequilibrium and vertigo. Studies have reported that the mean wait time from initial presentation of symptoms to successful treatment was 92 weeks; 85% of these patients had immediate symptom resolution after the first treatment session with a specialist trained in CRP.25 Improvement in recognition of BPPV at the primary care level will markedly reduce the lag time to treatment.
The author would like to thank Alan L. Desmond, AuD, and Dr. Brian Collie, ENT, for their mentorship and expertise in vestibular disorders.
