Hopp til hovedinnhold

Benign paroksysmal posisjonsvertigo

Sist revidert:
Sist revidert av:

Definisjon:
Forkortes BPPV og er en perifer vestibulær forstyrrelse
Forekomst:
Hyppigste årsak til akutt vertigo. Ettårs-prevalens ca. 1,6%, svarer til ca. 85 000 tilfeller i Norge årlig når også tilbakefall medregnes
Symptomer:
Karakterisert ved sterk rotatorisk vertigo i anfall som typisk varer under 30 sekunder, utløst av raske hodebevegelser eller i spesielle hodestillinger
Funn:
Svimmelhet og nystagmus lar seg oftest utløse ved stillingstester
Diagnostikk:
Symptomer + kliniske tester, Dix-Hallpikes stillingstest for påvisning av otolitter i bakre kanal, eller hodedreining i liggende stilling for påvisning av otolitter i horisontale kanal
Behandling:
Reponeringsmanøvre er førstevalg, mest brukt er Epleys manøver
  • Nasjonal kompetansetjeneste for vestibulære sykdommer - nettsted 
  1. You P, Instrum R, Parnes L. Benign paroxysmal positional vertigo. Laryngoscope Investig Otolaryngol. 2019 Feb; 4(1): 116–123. www.ncbi.nlm.nih.gov  
  2. Li JC. Benign paroxysmal positional vertigo. Medscape, last updated Mar 13, 2020. emedicine.medscape.com  
  3. Anagnostou E, Kouzi I, Spengos K. Diagnosis and treatment of anterior-canal benign paroxysmal positional vertigo: a systematic review. J Clin Neurol 2015; 11(3):262-7. PubMed  
  4. Parnes LS, Nabi S. Benign paroxysmal positional vertigo. BestPractice, last updated June 27, 2014 .
  5. Dix R, Hallpike CS. The pathology symptomatology and diagnosis of certain common disorders of the vestibular system. Ann Otol Rhinol Laryngol 1952; 61: 987-1016. PubMed  
  6. Von Brevern M, Radtke A, Lezius F, et al. Epidemiology of benign paroxysmal positional vertigo: a population based study. J Neurol Neurosurg Psychiatry. 2007 Jul;78(7):710-5. PubMed  
  7. Epley JM. The canalith repositioning procedure: for treatment of benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg 1992; 107: 399-404. PubMed  
  8. von Brevern M, Radtke A, Lezius F, et al. Epidemiology of benign paroxysmal positional vertigo: a population based study. J Neurol Neurosurg Psychiatr 2007; 78: 710-5. PubMed  
  9. Power L, Murray K, Szmulewicz DJ. Characteristics of assessment and treatment in Benign Paroxysmal Positional Vertigo (BPPV). J Vestib Res. 2019 Dec 13. PMID: 31839619. PubMed  
  10. Hansen S, Karlberg M. Benign paroksysmal positionel vertigo - den hyppigste form for otogen vertigo. Ugeskr Læger 2007; 169: 1996-2002. PubMed  
  11. Barton JJS. Benign paroxysmal positional vertigo. UpToDate, last updated Dec 17, 2018. UpToDate  
  12. Hilton MP, Pinder DK. The Epley (canalith repositioning) manoeuvre for benign paroxysmal positional vertigo. Cochrane Database Syst Rev. 2014 Dec 8;12:CD003162. Cochrane (DOI)  
  13. Fife TD, Iverson DJ, Lempert T, et al. Practice parameter: therapies for benign paroxysmal positional vertigo (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2008; 70: 2067-74. Neurology  
  14. Munoz JE, Miklea JT, Howard M, et al. Canalith repositioning maneuver for benign paroxysmal positional vertigo: randomized controlled trial in family practice. Can Fam Physician. 2007;53(6):1049-1048. PMID: 17872784. PubMed  
  15. Helminski JO, Zee DS, Janssen I, et al. Effectiveness of particle repositioning maneuvers in the treatment of benign paroxysmal positional vertigo: a systematic review. Phys Ther 2010; 90: 663-78. PubMed  
  16. Hilton MP, Pinder DK. The Epley (canalith repositioning) manoeuvre for benign paroxysmal positional vertigo. Cochrane Database Syst Rev. 2014;12:CD003162. PMID: 25485940 PubMed  
  17. Reinink K, Wegner I, Stegeman I, Grolman W. Rapid systematic review of repeated application of the epley maneuver for treating posterior BPPV. Otolaryngol Head Neck Surg 2014; 151: 399-406. pmid:24876167 PubMed  
  18. Hunt WT, Zimmermann EF, Hilton MP. Modifications of the Epley (canalith repositioning) manoeuvre for posterior canal benign paroxysmal positional vertigo (BPPV). Cochrane Database Syst Rev 2012; 4: CD008675. doi:10.1002/14651858.CD008675.pub2 DOI  
  19. Leveque M, Labrousse M, Seidermann L, et al. Surgical therapy in intractable benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg 2007; 136: 693-8. PubMed  
  20. Sakaida M, Takeuchi K, Ishinaga H, et al. Long-term outcome of benign paroxysmal positional vertigo. Neurology 2003; 60:1532. Neurology  
  21. Nunez RA, Cass SP, Furman JM. Short- and long-term outcomes of canalith repositioning for benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg 2000; 122: 647-52. PubMed  
  22. Laurent G, Vereeck L, Verbecque E, et al. Effect of age on treatment outcomes in benign paroxysmal positional vertigo: A systematic review. J Am Geriatr Soc. 2021. PMID: 34698378 PubMed  
  • Ingard Løge, spesialist i allmennmedisin, redaktør NEL

Tidligere fagmedarbeidere

  • Per Møller, spesialist i øre/nese/hals, Haukeland sykehus og professor ved Universitetet i Bergen
  • Stein Helge Glad Nordahl, øre-nese-hals spesialist, overlege Haukeland sykehus, Bergen