Abstract
Positional Manoeuvres for BPPV: Theoretical Approach to Remote Training for Non-specialists.
Highlights
The COVID 19 pandemic resulted in the extraordinary transition of many aspects of healthcare to “telemedicine” based platforms (1)
A history of recurrent brief episodes of spinning vertigo triggered by head movement suggests Benign paroxysmal positional vertigo (BPPV), but a definitive diagnosis lies on a positional manoeuvre which will elicit positional nystagmus in patients with the disorder
A manoeuvre such as the Dix-Hallpike should arguably be performed on every patient presenting with dizziness or imbalance because BPPV is common, carries an excellent treatment success rate, and dizzy symptoms are difficult for patients to describe
Summary
The COVID 19 pandemic resulted in the extraordinary transition of many aspects of healthcare to “telemedicine” based platforms (1). A manoeuvre such as the Dix-Hallpike should arguably be performed on every patient presenting with dizziness or imbalance because BPPV is common, carries an excellent treatment success rate, and dizzy symptoms are difficult for patients to describe (making history alone insufficient to make a confident diagnosis). Assessment of the dizzy patient requires a comprehensive understanding of theory, examination and obtaining an appropriate patient history to exclude other causes of positional vertigo, nystagmus and more sinister pathologies. This degree of comprehensive assessment may be beyond the remit of non-specialists without more intensive training.
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