耳石移位----BPPV---4

2007年5月13日下午12:09公開累積瀏覽 50

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HOME TREATMENT OF BPPV:

BRANDT-

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Lateral Canal BPPV, Anterior Canal BPPV, Cupulolithiasis, Vestibulolithiasis, Multicanal patterns

There are several rarer variants of BPPV which may occur spontaneously as well as after the Brandt-Daroff maneuvers or Epley/Semont maneuvers. They are mainly thought to be caused by migration of otoconial debris into canals other than the posterior canal, the anterior or lateral canal. There is presently no data reported as to the frequency and extent of these syndromes following treatment procedures. It is the author's estimate that they occur in roughly 5% of Epley maneuvers and about 10% of the time after the Brandt-Daroff exercises. In nearly all instances, with the exception of cupulolithiasis, these variants of BPPV following maneuvers resolve within a week without any special treatment, but when they do not, there are procedures available to treat them.

In clinical practice, atypical BPPV arising spontaneously is first treated with maneuvers as is typical BPPV, and the special treatments as outlined below are entered into only after treatment failure. When atypical BPPV follows the Epley, Semont or Brandt-Daroff maneuvers, specific exercises are generally begun as soon as the diagnosis is ascertained. In patients in whom the exercise treatment of atypical BPPV fails, especially in situations where onset is spontaneous, additional diagnostic testing such as MRI scanning may be indicated. The reason for this is to look for other types of positional vertigo.

Lateral canal BPPV it be able to get into more than one ? It is common to find small amounts of horizontal nystagmus or contralateral downbeating nystagmus in a person with classic posterior canal BPPV. While other explanations are possible, the most likely one is that there is debris in multiple canals.

WHERE ARE BPPV EVALUATIONS AND TREATMENTS DONE?

The Vestibular Disorders Association (VEDA) maintains a large and comprehensive list of doctors who have indicated a proficiency in treating BPPV. Please contact them to find a local treating doctor.