Materiały źródłowe

• #1 How to Reduce BPPV Recurrence | Vestibular First

  https://vestibularfirst.com/how-to-reduce-bppv-recurrence/?srsltid=AfmBOoo1UkFxYE_HinKoCfAqVauMXs9CmxGHJlx2NgVKUJb413qnTOJy

  Benign Paroxysmal Positional Vertigo, also known as BPPV, accounts for 20-30% of vestibular complaints (Sreenivas et al., 2021). […] Standard of care treatment for BPPV involves moving the otoconia back into the utricle via positional maneuvers as per the clinical practice guidelines (Bhattacharyya et al., 2017). […] Is there anything that can be done to reduce recurrence? Read on to learn more! […] Patients should work with their doctors on medical management of those conditions. For example, physicians can check a patients serum vitamin D level to make sure it is within normal limits. As long as not otherwise contraindicated medically, research has found that supplementation of Vitamin D 400 IU and 500 mg of calcium carbonate twice a day can reduce BPPV recurrence (Jeong et al., 2020; Jeong et al., 2022 thanks to Dr. Sue Whitney for providing these reference details for this newsletter).

• #2 Guide | Physical Therapy Guide to Benign Paroxysmal Positional Vertigo (BPPV) | Choose PT

  https://www.choosept.com/guide/physical-therapy-guide-benign-paroxysmal-positional-vertigo-bppv

  Can This Injury or Condition Be Prevented? […] There are no known ways to prevent BPPV. After treatment, symptoms can return if new crystals break off and get into the semicircular canal. […] Although your BPPV may return, you will be able to recognize the symptoms and keep yourself safe until you can get help. Your physical therapist will apply the appropriate maneuver to return the crystals to their correct position in the inner ear. They also may teach you exercises that can reduce or end your symptoms and improve your balance.

• #3 Benign Paroxysmal Positional Vertigo (BPPV) Symptoms & Treatment

  https://www.emedicinehealth.com/benign_positional_vertigo/article_em.htm

  Prevention begins by maintaining good hydration and avoiding rapid movements of the head. Should symptoms of vertigo begin, the following suggestions may be helpful: […] Most cases of BPPV do not have a known cause; therefore, no prevention is possible. […] There may be an association with minor head injury or repeatedly changing head position, for example working with a computer and constantly looking up and down at the monitor. […] As one gets older, it is reasonable to change positions a little more slowly to potentially prevent vertigo.

• #4 How to Reduce BPPV Recurrence | Vestibular First

  https://vestibularfirst.com/how-to-reduce-bppv-recurrence/?srsltid=AfmBOoo1UkFxYE_HinKoCfAqVauMXs9CmxGHJlx2NgVKUJb413qnTOJy

  Benign Paroxysmal Positional Vertigo, also known as BPPV, accounts for 20-30% of vestibular complaints (Sreenivas et al., 2021). […] Standard of care treatment for BPPV involves moving the otoconia back into the utricle via positional maneuvers as per the clinical practice guidelines (Bhattacharyya et al., 2017). […] Is there anything that can be done to reduce recurrence? Read on to learn more! […] Patients should work with their doctors on medical management of those conditions. For example, physicians can check a patients serum vitamin D level to make sure it is within normal limits. As long as not otherwise contraindicated medically, research has found that supplementation of Vitamin D 400 IU and 500 mg of calcium carbonate twice a day can reduce BPPV recurrence (Jeong et al., 2020; Jeong et al., 2022 thanks to Dr. Sue Whitney for providing these reference details for this newsletter).

• #5 Epley Maneuver (Canalith Repositioning Procedure)

  https://my.clevelandclinic.org/health/treatments/17930-canalith-repositioning-procedure-crp

  A canalith repositioning procedure (CRP) is a treatment for benign paroxysmal positional vertigo (BPPV), the most common cause of vertigo. […] Many healthcare providers recommend the Epley maneuver as the first line of treatment for BPPV. […] The Epley maneuver is a simple, noninvasive approach to treating benign paroxysmal positional vertigo (BPPV), a specific type of vertigo.

• #6 Benign Paroxysmal Positional Vertigo (BPPV)

  https://www.physio.co.uk/what-we-treat/vestibular/benign-paroxysmal-positional-vertigo-bppv.php/1000

  Physiotherapy is a successful way of curing BPPV and reducing the risk of you experiencing the condition in the future. […] Physiotherapy is an effective way of resolving the symptoms of BPPV by moving the crystals from areas that they are causing the vertigo. […] Advice on the management following the treatment will be also be provided. […] Your physiotherapy treatment at Physio.co.uk will depend on the symptoms that you are experiencing and the severity of your BPPV. […] Possible physiotherapy may include: The Epley Manoeuvre: this is a technique aimed at moving the crystals which are disrupting the vestibular system, to areas which will not cause any symptoms. […] Education about BPPV and its management. […] Physiotherapy is a very successful way of doing this and Physio.co.uk have specialist physiotherapists who are experienced at treating BPPV.

• #7 Benign Paroxysmal Positional Vertigo (BPPV): Treatment, Symptoms & Causes

  https://my.clevelandclinic.org/health/diseases/11858-benign-paroxysmal-positional-vertigo-bppv

  You cant prevent BPPV, but you can manage it with particle repositioning exercises. To reduce your risk of trauma-related BPPV, be sure to wear a helmet when biking, playing contact sports or participating in other similar activities. […] Your healthcare provider can teach you how to do BPPV exercises at home so you can manage your symptoms at the first sign of trouble.

• #8 Benign paroxysmal positional vertigo (BPPV) | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/benign-paroxysmal-positional-vertigo-bppv

  BPPV can be treated with simple exercises, taught by a doctor or physiotherapist who is familiar with the techniques required. […] If manoeuvres and exercises have been recommended, it is important to persist with the treatment because they provide a simple and non-invasive way to treat the vertigo and nausea associated with BPPV. […] BPPV can subside with time, but it is important to seek treatment in the early stages to prevent falls or injury. This is particularly important for older people when additional balance exercises may also be useful.

• #9 Benign Paroxysmal Positional Vertigo | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/b/benign-paroxysmal-positional-vertigo.html

  BPPV may be diagnosed and treated by your primary healthcare provider, an ear, nose, and throat (ENT) doctor (otolaryngologist), a neurologist, or often an emergency room healthcare provider. […] Your treatment may also include special physical therapy (vestibular rehabilitation). […] If you are still having symptoms from BPPV, your healthcare provider may tell you ways to avoid symptoms. For example: […] Even if you stop having symptoms, your healthcare provider may suggest that you follow similar instructions, at least for a few weeks. This may help prevent your symptoms from coming back. […] As you are recovering from BPPV, you may need to avoid certain head movements to help prevent your symptoms from coming back.

• #10 How to Reduce BPPV Recurrence | Vestibular First

  https://vestibularfirst.com/how-to-reduce-bppv-recurrence/?srsltid=AfmBOoo1UkFxYE_HinKoCfAqVauMXs9CmxGHJlx2NgVKUJb413qnTOJy

  Patients with these factors which may influence BPPV recurrence can be educated and encouraged to address any modifiable risk factors. We can also reassure patients that there are still people with none of those risk factors who get recurrence, so we just work on what we can manage and emphasize the importance of prompt treatment when BPPV does recur. […] Improving cervical extension and flexion has the potential to reduce the number of maneuvers needed to clear BPPV AND may decrease recurrence! […] While we must try to avoid converting posterior canal BPPV to lateral canal BPPV, with proper education and guided practice it can be appropriate to give a patient a home maneuver such as a self CRP (Helminski et al., 2010).

• #11

  https://myhealth.alberta.ca/Health/pages/conditions.aspx?hwid=hw263714

  Balance exercises for vertigo may help. Try standing with your feet together, arms down, and slowly moving your head from side to side. This may help you keep your balance and improve symptoms of vertigo. […] Staying as active as possible usually helps the brain adjust more quickly. But that can be hard to do when moving is what causes your vertigo. Bedrest may help, but it usually increases the time it takes for the brain to adjust. […] Be extra careful so that you don’t hurt yourself or someone else if you have a sudden attack of vertigo. You can reduce your risk of injury by taking precautions and making your living space safe. […] Your doctor may suggest that you do the Epley manoeuvre at home.

• #12 Dizziness Treatment (Vertigo) – Epley Maneuver – Fort Worth ENT

  https://fortworthent.net/audiology-hearing-loss/dizziness-treatment-benign-paroxysmal-positional-vertigo/

  Your doctor may recommend a neck evaluation and/or a neurological scan to ensure that treatment maneuvers can be performed safely or if they need to be modified. […] Some patients may be given vestibulosuppressant medication, or in extremely rare cases, a surgery called posterior canal occlusion (performed through a mastoidectomy approach) to block part of the inner ear may be needed to prevent the calcium crystals from moving back into the ear canal. […] Post BPPV treatment instructions may include: Sleeping propped up at a 45-degree angle or in a recliner for 2 nights, Keeping the head upright for 2 days (no bending over), Avoiding certain head movements that can precipitate BPPV. […] You may be given exercise techniques to incorporate at home which can ease residual unsteadiness or motion sensitivity.

• #13 Benign positional vertigo: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/001420.htm

  Avoid head positions that trigger positional vertigo.

• #14 Simple Ways to Avoid and Prevent Vertigo (BPPV) – Occupational Therapy Concept – Occupational Therapy in Long Island City

  https://otconcept.com/simple-ways-avoid-prevent-vertigo-bppv/

  BPPV or Benign Paroxysmal Positional Vertigo is when the crystals in your ear dislocated to the semicircular canals causing sensitivity to changes in positions. […] There are some restrictions that you can do or follow after a VR, if indicated by your therapist, to minimize recurrence. […] Avoid vertical head movement for 24 hrs. You would want to avoid moving your head in upward and downward direction, as if like Bobbing your head up and down. […] Avoid sleeping on the involved side for the next 2-3 nights. If your problem is on the right ear, avoid sleeping or laying on it for the next few days/nights. […] Sleep in semi-inclined (30 degrees) from the bed for 1 night. You can add more pillows on your head to make it higher, or you can use a soft wedge-type pillow on your head. […] Vitamin D intake with food. High dosage of Vit. D may assist in re-absorption of the Crystals from the inner ear back to the body, since Crystals are tiny pieces of Calcium Carbonate. You must consult with your physician before taking Vit D. […] You can reduce stress where possible, and avoid medications or drugs to reduce possible side effects will help with the vertigo, and have your physician check your Vitamin D levels.

• #15 Dizziness Treatment (Vertigo) – Epley Maneuver – Fort Worth ENT

  https://fortworthent.net/audiology-hearing-loss/dizziness-treatment-benign-paroxysmal-positional-vertigo/

  While treatments have shown to be highly effective (over 90% successful with 1-3 treatments), benign paroxysmal positional vertigo can often be a recurring condition with as many as 50% of patients experiencing another episode within 5 years of initial onset, especially in cases involving head trauma. […] If you are experiencing recurring vertigo, try these steps to ease symptoms until you are able to consult your specialist: Avoid sleeping on the side that brings on vertigo symptoms, Sleep propped up with 2 or more pillows, Avoid bending over if possible, Upon awakening, lift the head slowly and sit at the edge of the bed before standing, Sit down if you begin to feel dizzy.

• #16 Prevention of Recurrent Benign Paroxysmal Positional Vertigo: The Role of Combined Supplementation with Vitamin D and Antioxidants

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9404917/

  Benign paroxysmal positional vertigo (BPPV) usually has a favorable course, although it is possible to observe BPPV with a high recurrence rate. […] Previous studies suggested that vitamin D deficiency might affect BPPV recurrences, and oxidative stress might play a complementary role in BPPV pathogenesis. […] This multicentric trial aimed to evaluate the effectiveness of oral nutritional supplementation with a compound of alpha-lipoic acid, Carnosine, and Zinc (LICA), vitamins of group B and vitamin D in preventing BPPV recurrences. […] Study results suggested that oral nutritional supplementation with vitamin D3 plus antioxidants can prevent relapses in patients suffering from high recurrence-BPPV. […] The vitamin D status depends on the production of vitamin D3 in the skin under the influence of ultraviolet radiation and vitamin D intake through the diet or vitamin D3 supplements.

• #17

  https://link.springer.com/article/10.1007/s00415-020-09952-8

  Vitamin D insufficiency/deficiency is known to be related to occurrences and recurrences of benign paroxysmal positional vertigo (BPPV). […] We performed a meta-analysis to determine the therapeutic effects of vitamin D supplementation, with or without calcium, for preventing recurrences of BPPV. […] The analyses showed a significant preventive effect on the recurrences of BPPV (RR=0.37; 95% CI=0.180.76; p=0.007 with the random-effects model) with supplementation of vitamin D. […] Vitamin D supplementation provides a benefit for secondary prevention of BPPV. Supplementation of vitamin D should be considered in patients with frequent attacks of BPPV, especially when serum vitamin D is subnormal.

• #18 Prevention of Recurrent Benign Paroxysmal Positional Vertigo: The Role of Combined Supplementation with Vitamin D and Antioxidants

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9404917/

  Our study, confirming the observation reported by a study performed on the north Sardinia population, indicates that patients with complicated BPPV should be considered patients at high risk of hypovitaminosis D and suggests the opportunity to perform the vitamin D assessment routinely in patients with relapsed BPPV in addition to the standard treatment with repositioning maneuvers. […] Therefore, oral nutritional supplementation with vitamin D3 probably promotes a positive effect in the prevention of labyrintholithiasis by exerting a direct action on calcium metabolism in the inner ear, which improves otolith compactness, reducing their detachment. […] This study suggested that oral nutritional supplementation with a compound of vitamin D3, ALA, Carnosine, and Zinc (LICA), vitamins of group B, can prevent relapses and reduce symptoms related to high-recurrence BPPV in patients showing insufficient or deficient serum concentration of 25 (OH) D. […] The administration of vitamin D in association with a powerful antioxidant (LICA) enhances its effects resulting in reducing the risk of developing new episodes of BPPV and improving its clinical course after maneuvers.

• #19 How to Reduce BPPV Recurrence | Vestibular First

  https://vestibularfirst.com/how-to-reduce-bppv-recurrence/?srsltid=AfmBOoo1UkFxYE_HinKoCfAqVauMXs9CmxGHJlx2NgVKUJb413qnTOJy

  Benign Paroxysmal Positional Vertigo, also known as BPPV, accounts for 20-30% of vestibular complaints (Sreenivas et al., 2021). […] Standard of care treatment for BPPV involves moving the otoconia back into the utricle via positional maneuvers as per the clinical practice guidelines (Bhattacharyya et al., 2017). […] Is there anything that can be done to reduce recurrence? Read on to learn more! […] Patients should work with their doctors on medical management of those conditions. For example, physicians can check a patients serum vitamin D level to make sure it is within normal limits. As long as not otherwise contraindicated medically, research has found that supplementation of Vitamin D 400 IU and 500 mg of calcium carbonate twice a day can reduce BPPV recurrence (Jeong et al., 2020; Jeong et al., 2022 thanks to Dr. Sue Whitney for providing these reference details for this newsletter).

• #20 What can I do to prevent BPPV? – PhysioFit of NC

  https://www.physiofitnc.com/what-can-i-do-to-prevent-bppv/

  Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vertigo disease. […] The previous lists help explain to patients why do I have BPPV? or even what can I do to prevent BPPV?. […] Modifiable risk factors are ones that you have more control over to prevent or reduce. […] To put the quotes into general terms for you all, it basically means that having an active lifestyle through exercise and avoiding sustained lying down positions (i.e. recumbent positions) can be the solution to help preventing BPPV and reducing risk for it coming back! […] We do recommend exercises that are not just linear, but involve rotation of your body, stimulate your vestibular system and involve multiple positions of your trunk and head. These are highly prevalent in a yoga or Tai Chi practice.

• #21 Benign Paroxysmal Positional Vertigo – What You Need to Know

  https://www.drugs.com/cg/benign-paroxysmal-positional-vertigo.html

  Your healthcare provider will teach you how to move your head and body to prevent symptoms. For example, he or she may teach you certain ways to move your head or body. These movements usually help relieve your symptoms and keep the dizziness from returning. The exercises help move the calcium pieces to a different part of your ear. Do the movements only as directed. […] Try to avoid sudden head movements. Stand up and lie down slowly. […] Raise and support your head when you lie down. Place pillows under your upper back and head or rest in a recliner. […] Change your position often when you are lying down. Try not to lie with your head on the same side for long periods of time. Roll over slowly. […] Wear protective gear when you ride a bike or play sports. A helmet helps protect your head from injury.

• #22 Benign Paroxysmal Positional Vertigo (BPPV) Symptoms & Treatment

  https://www.emedicinehealth.com/benign_positional_vertigo/article_em.htm

  Prevention begins by maintaining good hydration and avoiding rapid movements of the head. Should symptoms of vertigo begin, the following suggestions may be helpful: […] Most cases of BPPV do not have a known cause; therefore, no prevention is possible. […] There may be an association with minor head injury or repeatedly changing head position, for example working with a computer and constantly looking up and down at the monitor. […] As one gets older, it is reasonable to change positions a little more slowly to potentially prevent vertigo.

• #23 Benign Paroxysmal Positional Vertigo – Ear, Nose, and Throat Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/ear-nose-and-throat-disorders/inner-ear-disorders/benign-paroxysmal-positional-vertigo

  Benign paroxysmal positional vertigo (BPPV) is the most common cause of relapsing otogenic vertigo. […] Because BPPV is fatigable, one therapeutic approach is to have the patient perform provocative maneuvers early in the day in a safe environment. Symptoms are then minimal for the rest of the day. […] Treat with canalith-repositioning maneuvers. […] Medications rarely help and may worsen symptoms.

• #24

  https://www.myactionpt.com/physical-therapist-s-guide-to-benign-paroxysmal-positional-vertigo-bppv

  No known ways exist to prevent BPPV, especially when caused by such factors as head injury or aging. […] Once a person has experienced BPPV, symptoms can return if new crystals break off and get into the semicircular canal, or if you dislodge loose crystals by placing your head in a certain position. […] Some people report that their BPPV symptoms recur predictably, perhaps seasonally, or with changes in the weather. […] Within 3 years of having BPPV, about 50% of people may have a recurrence. […] BPPV resulting from head trauma is more likely to recur. […] Although your BPPV might return, you’ll be able to recognize the symptoms and keep yourself safe until you can get help. […] Your physical therapist will apply the appropriate maneuver to return the crystals to their correct position in the inner ear, and also will teach you how to do exercises that can reduce or eliminate the symptoms.

• #25 Benign Paroxysmal Positional Vertigo: Symptoms and Treatment

  https://patient.info/signs-symptoms/dizziness/benign-paroxysmal-positional-vertigo

  The DVLA states that you should stop driving if you have sudden, unexpected and disabling attacks of dizziness: Dizziness or vertigo and driving – GOV.UK (www.gov.uk). […] You should inform your employer if BPPV could pose a risk to yourself or others in your job. For example, if you use ladders, operate heavy machinery, or drive. […] To avoid falls around the home, get out of bed slowly and avoid jobs around the house that involve looking upwards if possible.

• #26 Benign Paroxysmal Positional Vertigo (BPPV) | HealthLink BC

  https://www.healthlinkbc.ca/healthwise/benign-paroxysmal-positional-vertigo-bppv

  BPPV may go away in a few weeks by itself. If treatment is needed, it usually involves your doctor moving your head in different directions. […] Watchful waiting is a wait-and-see approach. It may be okay to try it if your symptoms suggest BPPV and this is not your first attack. Over time, BPPV may go away on its own. But treatment with a simple procedure in your doctor’s office (either the Epley or Semont manoeuvre) can usually stop your vertigo right away. Talk to your doctor. If your vertigo interferes with your normal daily activities or causes nausea and vomiting, you may need treatment. […] You can reduce the whirling or spinning sensation of vertigo when you have benign paroxysmal positional vertigo (BPPV) by taking these steps. […] Staying as active as possible usually helps the brain adjust more quickly. But that can be hard to do when moving is what causes your vertigo. Bedrest may help, but it usually increases the time it takes for the brain to adjust. […] Be extra careful so that you don’t hurt yourself or someone else if you have a sudden attack of vertigo. You can reduce your risk of injury by taking precautions and making your living space safe.

• #27 Benign paroxysmal positional vertigo (BPPV) | Healthify

  https://healthify.nz/health-a-z/b/benign-paroxysmal-positional-vertigo-bppv

  Because vertigo in BPPV can affect your balance and may make you feel unsteady, you are at risk of falls or accidents. To reduce your risk of a fall or accident: […] let your employer know about your symptoms, especially if your job involves operating machinery or climbing ladders.

• #28 Benign Paroxysmal Positional Vertigo | Audiology Consultants LLC

  https://www.audiologyconsultants.net/benign-paroxysmal-positional-vertigo.php

  To prevent recurrence, certain exercises that train the brain to resist vertigo-inducing signals can be performed. […] Although severe symptoms can be managed with medication, they may cause BPPV to last longer.

• #29 Benign Paroxysmal Positional Vertigo: Symptoms and Treatment

  https://patient.info/signs-symptoms/dizziness/benign-paroxysmal-positional-vertigo

  Benign paroxysmal positional vertigo usually causes short episodes of intense dizziness or vertigo when the head is moved in certain directions. […] A simple treatment of moving the head into various positions over a few minutes can cure the condition in many cases. This treatment uses gravity to move the tiny fragments away from where they are causing problems. […] In most cases, the symptoms clear away within a few weeks or months. The solid fragments (otoconia) may dissolve or float out from the posterior semi-circular canal and lodge in the vestibule where they cause no symptoms. […] Benign paroxysmal positional vertigo is a condition that can go away on its own after several weeks or months without any treatment. The otoconia are thought either to dissolve or move to a place in the labyrinth where they cause no symptoms.

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