Zappia John J
Michigan Ear Institute, Farmington Hills, MI 48334, USA.
Curr Opin Otolaryngol Head Neck Surg. 2013 Oct;21(5):480-6. doi: 10.1097/MOO.0b013e32836463d6.
To review benign paroxysmal positional vertigo (BPPV) and some of the recent literature. As BPPV is such a common diagnosis, it is important to understand the disorder and treatment considerations.
Although BPPV is typically an easy diagnosis to make, one must be aware of the differential diagnosis. An unusual entity, convergence spasm, is recently presented and discussed as an addition to the differential diagnosis. The recent literature confirms the efficacy of treatment of BPPV. Large studies of horizontal canal BPPV support the success of the barbeque roll and present the simple head shake as a possible treatment in the apogeotropic form. There is reported success with the less often discussed Gufoni (and its variations) maneuver. The presence of orthoptic nystagmus during treatment has positive predictive value for the success of the maneuver. Although uncommon, canal conversion is important to recognize during treatment as it can be readily treated.
BPPV is a very common cause of dizziness and generally straightforward to identify and treat. Awareness of possible horizontal canal variants and nonvestibular differential diagnosis possibilities is important. Repositioning maneuvers of various types are typically successful and understanding the nuances is important in assuring successful outcomes.
回顾良性阵发性位置性眩晕（BPPV）及一些近期文献。由于BPPV是一种常见诊断，了解该疾病及其治疗注意事项很重要。
尽管BPPV通常易于诊断，但必须了解鉴别诊断。最近提出并讨论了一种不常见的情况——集合痉挛，作为鉴别诊断的补充。近期文献证实了BPPV治疗的有效性。关于水平半规管BPPV的大型研究支持烧烤翻滚法的成功，并提出简单摇头法可作为背地性形式的一种可能治疗方法。有报道称较少讨论的Gufoni（及其变体）手法也取得了成功。治疗期间出现视轴矫正性眼球震颤对该手法的成功具有阳性预测价值。尽管不常见，但在治疗过程中识别半规管转换很重要，因为它很容易治疗。
BPPV是头晕的常见原因，通常易于识别和治疗。了解可能的水平半规管变体和非前庭性鉴别诊断可能性很重要。各种类型的复位手法通常是成功的，了解其中的细微差别对于确保成功结果很重要。
