Summary
Benign paroxysmal positional vertigo (BPPV) and its subtypes are caused by dislocation
of otoliths or clotted otolith fragments, which can be deposed within the three semicircular
canals. Primary and secondary forms are differentiated. Non-responders of treatment
by means of different positional head manoevers have to be examined in detail to exclude
central nervous diseases or the involvement of more semicircular canals ipsi- and
contralaterally. The observation of the nystagmus direction and the angular point
of torsional nystagmus in Dix-Hallpike or is crucial. According to the results of
diagnostic positional tests and barbecue rotation manoevers different subtypes of
BPPV have to be differentiated and must be treated by different treatment strategies.
In rare cases only posterior semicircular canal occlusion is indicated.
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1 Auszugsweise vorgetragen auf der Versammlung Westdeutscher Hals-Nasen-Ohrenärzte
2006 in Aachen
