Case Study: 42-years male patient experienced of episodes of vertigo and he was

Question

Case Study:

42-years male patient experienced of episodes of vertigo and he was refer to neurologist. He was diagnose with benign paroxysmal positional vertigo (BPPV). He reported to doctor that his vertigo occurs when rolling over the bed, or when turn his head side to side in sitting position, which provokes sensation of spinning of the room and later nausea. Doctor confirm the BPPV by using a very special test called Dix-Hallpike maneuver. During the test neurologist was monitoring for nystagmus as he makes specific rotational changes to patient’s head position.

1. Explain which mechanism(s) is/are a likely explanation for this patient’s condition?

Explanation / Answer

Benign paroxysmal positional vertigo is common cause of vertigo.this diseases is associated with positioning changes that were attributed at the time of otolith organ (contains crystals sensitised to gravity present in vestibular labrinth of inner ear).

The cardinal symptoms induced when patients change their head position, turning over in bed, lying down in bed, looking up and stooping.

The mechanism of BPPV is explained by cupulolithiases thoery.

It states that otolith debris( heavy cupula) present in inner ear would induce a gravitional effect on crista these capular deposites move under the influence of gravity when changing the position of semicircular canal of ear in earth vertical plane. This drag causes endolymphatic flow resulting in capular displacement and responses arise.

It is also observed that BPPV is uticular abnormalities and myogenic potentials of horzontal positioning during off vertical axis rotation.

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