Public Health and Primary CareCASE REPORTS

Management of Benign Paroxysmal Positional Vertigo With the Canalith Repositioning Maneuver in the Emergency Department Setting

David B. Burmeister, DO; Regina Sacco, DPT, NCS; and Valerie Rupp, RN, BSN
Notes and Affiliations
Notes and Affiliations

Received: March 26, 2009

Accepted: February 25, 2010

Published: October 1, 2010

J Osteopath Med; 110(10): 602-604

Vertigo is a common clinical manifestation in the emergency department (ED). It is important for physicians to determine if the peripheral cause of vertigo is benign paroxysmal positional vertigo (BPPV), a disorder accounting for 20% of all vertigo cases. However, the Dix-Hallpike test—the standard for BPPV diagnosis—is not common in the ED setting. If no central origin of the vertigo is determined, patients in the ED are typically treated with benzodiazepine, antihistamine, or anticholinergic agents. Studies have shown that these pharmaceutical treatment options may not be the best for patients with BPPV. The authors describe a case of a 38-year-old woman who presented to the ED with complaints of severe, sudden-onset vertigo. The patient’s BPPV was diagnosed by means of a Dix-Hallpike test and the patient was acutely treated in the ED with physical therapy using the canalith repositioning maneuver.

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