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ENT doctors release national guideline on treatment for common cause of dizziness
Date:10/31/2008

tely, BPPV can be readily diagnosed by clinicians in an outpatient setting most of the time without complicated testing. Once a proper diagnosis has been made, simple, effective treatment options are available to relieve symptoms quickly.

Some of the key recommendations of the guideline include:

  • A strong recommendation for clinicians to diagnose posterior semicircular canal BPPV with an office-based diagnostic test (the Dix-Hallpike maneuver, detailed within the guideline).
  • A recommendation for clinicians to also test patients for a second type of BPPV affecting the lateral semicircular canal when initial testing is not conclusive (using the supine roll test).
  • Clinicians should differentiate BPPV from other causes of imbalance, dizziness, and vertigo.
  • Clinicians should question patients with BPPV for factors that modify management including impaired mobility or balance, CNS disorders, a lack of home support, and increased risk for falling. These recommendations will help prevent some of the dangerous morbidities from BPPV.
  • Clinicians should not obtain radiographic imaging or vestibular testing in a patient diagnosed with BPPV, unless the diagnosis is uncertain or there are additional symptoms or signs unrelated to BPPV that warrant testing.
  • Clinicians should not routinely treat BPPV with vestibular suppressant medications such as antihistamines or benzodiazepines.
  • For patients who are initial treatment failures, clinicians should evaluate them for persistent BPPV or underlying peripheral vestibular or CNS disorders.
  • Clinicians should counsel patients regarding the impact of BPPV on their safety, the potential for disease recurrence, and the importance of follow-up.

The guideline was created by a multidisciplinary panel of clinicians representing the fields of otolaryngology, audiology, emergency medicine, physical medicin
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Contact: Jessica Mikulski
newsroom@entnet.org
703-535-3762
American Academy of Otolaryngology -- Head and Neck Surgery
Source:Eurekalert

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