DIAGNOSIS AND TREATMENT OF BENIGN PAROXYSMAL POSITION VERTIGO

Benigni paroksizmalni pozicijski vertigo smatra se jednim od najčešćih uzroka vrtoglavica. Obilježava ga jaki napadaj vrtoglavice koji obično traje nekoliko sekundi i javlja se kod promjena položaja glave. Nastaje zbog slobodnog polutanja prethodnog odvojenog kristalića otolita u vestibularnom osjetilu unutarnjeg uha. Uzrok je obično nepoznat i tada se radi o primarnom ili idiopatskom BPPV-u dok kod sekundarnog postoje razni uzroci. BPPV se prema mjestu nakupljanja otolita dijeli na najčešću kanalolitijazu te rijetku kupulolitijazu. Postoje još i vrlo rijetke vestibulolitijaza i kristolitijaza koje su nedovoljno istražene. Prema zahvaćenosti polukružnog kanalića BPPV se dijeli na BPPV stražnjeg polukružnog kanalića (PC BPPV), BPPV lateralnog polukružnog kanalića (HC BPPV) i BPPV prednjeg polukružnog kanalića (AC BPPV). Dijagnosticira se Dix-Hallpike probom i Supine-roll testom. Liječenje se vrši repozicijskim manevrima kojima je cilj vratiti otolite u prvobitni položaj. Neki od repozicijskih testova koji se koriste su: Epley repozicijski postupak, Semontov postupak oslobođenja, Barbecue roll postupak, Casanijev postupak, Yacovinov manevar. Izbor postupka koji će se primijeniti ovisi o tome koji je polukružni kanalić zahvaćen. Liječenje ovim postupcima vrlo je uspješno i već nakon prve primjene dolazi do značajnog poboljšanja.Benign paroxysmal positional vertigo is considered to be one of the most common causes of vertigo. It is characterized by a severe attack of dizziness that usually lasts a few seconds and occurs when the position of the head changes. It is caused by the free movement of the previously separated otolith crystal in the vestibular sense of the inner ear. The cause is usually unknown and then it is primary or idiopathic BPPV while in secondary there are various causes. BPPV is divided according to the site of otolith accumulation into the most common canalolithiasis and the rare cupulolthiasis. There are also very rare vestibulolithiasis and cristolithiasis that have been insufficiently studied. According to the involvement of the semicircular canal, BPPV is divided into BPPV of the posterior semicircular canal (PC BPPV), BPPV of the lateral semicircular canal (HC BPPV) and BPPV of the anterior semicircular canal (AC BPPV). It is diagnosed by Dix-Hallpike test and Supine-roll test. Treatment is performed with repositioning maneuvers aimed at restoring the otoliths to their original position. Some of the repositioning tests used are: Epley repositioning procedure, the Semont release procedure, the Barbecue roll procedure, the Casani procedure, the Yacovin maneuver and many others. Treatment with these procedures is very successful and already after the first applications there is a significant improvement