Gå direkt till huvudinnehållet

Benign paroxysmal positionell vertigo (BPPV)

Senast uppdaterad: Senast reviderad:


Definition:
Benign paroxysmal positionell vertigo förkortas BPPV och är en perifer vestibulär rubbning.
Förekomst:
20 % av de som besväras av yrsel har BPPV. Högst incidens hos personer mellan 50–70 år.
Symtom:
Episodisk, kortvarig yrsel som utlöses av huvudrörelser. 
Kliniska fynd:
Provokationstester visar i regel nystagmus.
Diagnostik:
Diagnosen baseras på symtom och kliniska fynd. Ytterligare utredning är i regel inte indicerad.
Behandling:
Lugnande besked. Partikelreponeringsmanövrer såsom Epleys manöver och Semonts manöver har ofta god effekt. 
  1. Anagnostou E, Kouzi I, Spengos K. Diagnosis and treatment of anterior-canal benign paroxysmal positional vertigo: a systematic review. J Clin Neurol 2015; 11(3):262-7. PubMed  
  2. Kim JS, Zee DS. Clinical practice. Benign paroxysmal positional vertigo. N Engl J Med. 2014 Mar 20;370(12):1138-47. doi: 10.1056/NEJMcp1309481. DOI  
  3. von Brevern M, Bertholon P, Brandt T, et al. Benign paroxysmal positional vertigo: Diagnostic criteria. J Vestib Res 2015; 25(3-4): 105-17. pmid:26756126 PubMed  
  4. Dix R, Hallpike CS. The pathology symptomatology and diagnosis of certain common disorders of the vestibular system. Ann Otol Rhinol Laryngol 1952; 61: 987-1016. PubMed  
  5. Oghalai JS, Manolidis S, Barth JL et al. Unrecognized benign paroxysmal positional vertigo in elderly patients. Otolaryngol Head Neck Surg 2000; 122: 630-4. PubMed  
  6. von Brevern M, Radtke A, Lezius F, et al. Epidemiology of benign paroxysmal positional vertigo: a population based study. J Neurol Neurosurg Psychiatr 2007; 78: 710-5. PubMed  
  7. Hanley K, O'Dowd T. Symptoms of vertigo in general practice: a prospective study of diagnosis. Br J Gen Pract 2002; 52: 809-12. www.ncbi.nlm.nih.gov  
  8. Steenerson RL, Cronin GW, Marbach PM. Effectiveness of treatment techniques in 923 cases of benign paroxysmal positional vertigo. Laryngoscope 2005; 115: 226-31. PubMed  
  9. Argaet EC, Bradshaw AP, Welgampola MS. Benign positional vertigo, its diagnosis, treatment and mimics. Clin Neurophysiol Pract 2019; 4: 97-111. pmid:31193795 PubMed  
  10. Kentala E, Pyykko I. Vertigo in patients with benign paroxysmal positional vertigo. Acta Otolaryngol Suppl 2000; 543: 20-2. PubMed  
  11. Hilton MP, Pinder DK. The Epley (canalith repositioning) manoeuvre for benign paroxysmal positional vertigo. Cochrane Database Syst Rev. 2014 Dec 8;12:CD003162. Cochrane (DOI)  
  12. Helminski JO, Zee DS, Janssen I, et al. Effectiveness of particle repositioning maneuvers in the treatment of benign paroxysmal positional vertigo: a systematic review. Phys Ther 2010; 90: 663-78. PubMed  
  13. Prokopakis E, Vlastos IM, Tsagournisakis M, et al. Canalith repositioning procedures among 965 patients with benign paroxysmal positional vertigo. Audiol Neurootol 2013; 18(2): 83-8. pmid:23147839 PubMed  
  14. Braschi E, Ross D, Korownyk C. Evaluating the Epley maneuver. Can Fam Physician 2015; Oct;61(10): 878. pmid:26472794 PubMed  
  15. Helminski JO, Zee DS, Janssen I, et al. Effectiveness of particle repositioning maneuvers in the treatment of benign paroxysmal positional vertigo: a systematic review. Phys Ther 2010; 90: 663-78. PubMed  
  16. You P, Instrum R, Parnes L. Benign paroxysmal positional vertigo. Laryngoscope Investig Otolaryngol 2018; 4(1): 116-123. pmid:30828628 PubMed  
  17. Humphriss RL, Baguley DM, Sparkes V, Peerman SE, Moffat DA. Contraindications to the Dix-Hallpike manoeuvre: a multidisciplinary review. Int J Audiol 2003; 42: 166-73. PubMed  
  18. Leveque M, Labrousse M, Seidermann L, et al. Surgical therapy in intractable benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg 2007; 136: 693-8. PubMed  
  19. Asawavichianginda S, Isipradit P, Snidvongs K, Supiyaphun P. Canalith repositioning for benign paroxysmal positional vertigo: a randomized, controlled trial. Ear Nose Throat J 2000; 79: 732-4. PubMed  
  20. White J, Sawides P, Cherian N, et al. Canalith repositioning for benign paroxysmal positional vertigo. Otol Neurotol 2005; 26: 704-10. PubMed  
  21. Sakaida M, Takeuchi K, Ishinaga H, Adachi M, Majima Y. Long-term outcome of benign paroxysmal positional vertigo. Neurology 2003; 60: 1532-4. Neurology  
  22. White J, Sawides P, Cherian N, et al. Canalith repositioning for benign paroxysmal positional vertigo. Otol Neurotol 2005; 26: 704-10. PMID:16015173. PubMed  
  • Remy Waardenburg, specialist i allmänmedicin, medicinsk redaktör Medibas

Tidigare sakkunniga

  • Mikael Karlberg, docent och överläkare, ÖNH-kliniken, Skånes universitetssjukhus samt ÖNH-mottagningen, Trelleborgs lasarett