Optimal management of benign paroxysmal positional vertigo patients: An unmet need.

Background Benign paroxysmal positional vertigo (BPPV) is considered to be the most common type of vertigo. There is strong evidence supporting the role of  Dix Hallpike maneuver in diagnosing  BPPV, and canalith repositioning maneuver CRM  in managing it; but  these maneuvers are underutilized. Material and methods: A prospective study was conducted in the Department of Neurology in a tertiary care center referral hospital in Kashmir, north India. All the patients of vertigo diagnosed as BPPV were included in study. History and examination was done and patients were followed to see the response of treatment. There referrals notes, previous  records were checked for the diagnosis, treatment and investigations done for managing their  complaints were studied and recorded. Results: Out of total of 101 patients diagnosed as BPPV, 77  were females and 24 were males with M:F ratio as 1: 3.2 . The frequency of various subtypes of BPPV were:  posterior canal in 96 patients, horizontal canal in 4 and anterior canal in one. On reviewing records  of patients only 10% of  had been given diagnosis of BPPV .All patients had been treated with labyrinthine sedatives and other medications  and none had been offered CRM.84% patients had  undergone various  unnecessary investigations . Conclusion. A vast majority of patients with BPPV don’t get an accurate diagnosis in their first contact with health care professionals. Most of the patients undergo unnecessary investigations .CRMs  like Epley’s maneuver are not offered to BPPV patients even though they are the standard of care in this condition.