RIGHT BPPV- ANTERIOR OR POSTERIOR

This video shows Dix-Hallpike positioning done by Dr. Ajay Kumar Vats, D.M. (Neurology), Udaipur (Rajasthan), India, on a patient with right (posterior/anterior) semicircular canal BPPV. This patient had a closed head trauma four days prior to complaints of vertigo. This elicited nystagmus in the Hallpike position on right but the type of nystagmus could not be characterized as patient closed his eyes partially during Dix-Hallpike positioning (this is common because the severity of peripheral vertigo decreases with eye closure). Voluntary eye closure interferes with examination of the type of nystagmus which is important for identifying the involved canal. After lateralization of the diseased ear, the localization of the involved canal is important as far as diagnosis is concerned. However once lateralization of the diseased ear is established, for the treatment purpose it doesn't matter whether it is posterior or anterior canal which is affected as both anterior and posterior canal BPPV are treatable with Epley maneuver. Epley maneuver was done by Dr. A. K. Vats on this patient and he was free of vertigo after single time performed Epley maneuver.