My first new patient of the week was one of the first I was able to discharge this week. Benign Paroxysmal Peripheral Vertigo (BPPV) can be a very disabling problem. There are many potential reasons for someone to be dizzy, but if BPPV is your problem, it can usually be fixed in one visit. Most of the evaluation is spent screening for other neurologic conditions that could be causing the dizziness, such as stroke. In his case, the problem was a posterior canalisthiasis, that was causing him to feel as though the room were spinning, set off by the position of his head.
It was corrected by a canalith repositioning maneuver. The direction and progression of the movement is dictated by the direction and type of nystagmus (eye movements) during a Hallpike-Dix testing maneuver. His symptoms were relieved immediately, and he was given a set of basic instructions to follow for the next 48-hours to avoid a relapse of the problem.
As with most BPPV/Vertigo patients, an accurate evaluation leads to quick treatment in the same visit, and no need for a follow-up appointment.