REPOSITIONING MANOEUVRES AS KINESIOTHERAPY-BASED TREATMENT FOR BENIGN PAROXYSMAL POSITIONAL VERTIGO (BPPV)

Dizziness is a very common symptom in general medical practice (5% of family doctor appointments, according to the data provided by the World Health Organization). Therefore, the patient with dizziness needs to be approached very carefully, their medical history being the key element for the correct evaluation of each patient. The primary purpose of the medical consultation is not to establish the aetiology of the disease, but to find the main cause of dizziness - vestibular/inner ear, neurological or other pathological conditions. It is thus essential to know very well the clinical and paraclinical information in order to make a correct differential diagnosis and apply the most beneficial treatment. More than 40% of peripheral vestibular pathology is represented by benign paroxysmal positional vertigo (BPPV), a disease characterised by the displacement of the otolithic structure from the macular region to the semicircular canal. Patients will have the sensation of true vertigo when rolling in bed, getting up from the bed or bending forward. Specialised bedside examination with a specific magnifying glass or infrared camera allows the physician to establish the precise location and mechanism of the disease. Once the affected semicircular canal is established by the ENT or neurologist, treatment usually consists of repositioning manoeuvres. These could be performed by trained physicians, audiologists and physiotherapists. The most used manoeuvres will be described in this paper.