ENT: Benign Positional Vertigo: Free MSRA Podcast

⚕️ FREE MSRA PODCAST – Benign Paroxysmal Positional Vertigo (BPPV)🎧 A clear, high-yield breakdown of this common inner ear cause of vertigo – perfect for exam prep and real-life clinical scenarios.🧠 Key Learning Points📌 Definition• Inner ear disorder causing brief, positional episodes of vertigo• Triggered by head movements – e.g. rolling over in bed• Caused by dislodged calcium crystals (otoconia) disrupting balance signals📌 Causes & Risk Factors• Idiopathic (most common)• Head trauma 🧠• Inner ear infections• Age-related degeneration (esp. 50–70 years)• Meniere’s disease• Female sex (2x more common than in males)• Migraine & anxiety (esp. in children)• Family history, previous BPPV episodes💡 Mnemonic: “CHIMPS FAM” – Crystals, Head injury, Infections, Meniere’s, Postural, Sex (female), Family hx, Ageing, Migraine📌 Pathophysiology• Otoconia detach from utricle ➡️ enter semicircular canals• Disrupt endolymph flow during movement• Brain receives exaggerated or false movement signals• Result = sudden spinning sensation (vertigo)📌 Symptoms• Vertigo lasting <1 minute• Triggered by positional changes (e.g. looking up, lying down)• Nausea ± vomiting 🤢• No hearing loss or tinnitus• Unsteadiness between attacks💡 Worse in the morning; relieved by staying still📌 Differential Diagnosis• Vestibular neuritis• Meniere’s disease• Vestibular migraine• Central causes: stroke, MS, brainstem tumour🚨 Red Flags:• Unilateral hearing loss 👂• Tinnitus• Neurological signs (e.g. facial weakness, vision changes)• Severe/new headache• Atypical nystagmus→ Urgent imaging/referral required📌 Diagnosis• Clinical diagnosis• History + examination🧪 Dix-Hallpike test = key: – Patient lies back with head rotated – Positive = vertigo + torsional nystagmus🧠 Typical = fatigable, short-latency, resolves when still❌ Imaging (MRI) only if red flags or atypical presentation📌 Management✅ Repositioning maneuvers• Epley maneuver = first-line• Brant-Daroff exercises (home-based)💊 Medications (short-term relief only):• Antihistamines (e.g. cinnarizine)• Betahistine• Anticholinergics🏃 Vestibular rehab for lingering imbalance🕰️ Often self-resolves over weeks–months⚠️ Avoid triggers (e.g. sudden head turns) until stable🔁 Recurrence common – ~50% within 5 years🔍 Refer if: non-resolving, diagnostic uncertainty, red flags📌 Complications• Falls – esp. in elderly 🚨• Anxiety, fear of recurrence• Significant impact on QoL and confidence• Rarely, serious injury from sudden attacks📌 Prognosis• Excellent with treatment ✅• Most improve quickly after Epley maneuver• May recur, but usually managed effectively each time📎 More MSRA Resources for BPPV📝 Revision Notes:https://www.passthemsra.com/topic/benign-positional-paroxysmal-vertigo-revision-notes/🧠 Flashcards:https://www.passthemsra.com/topic/benign-positional-paroxysmal-vertigo-flashcards/💬 Accordion Q&A Notes:https://www.passthemsra.com/topic/benign-positional-paroxysmal-vertigo-accordion-qa-notes/🚀 Rapid Quiz:https://www.passthemsra.com/topic/benign-positional-paroxysmal-vertigo-rapid-quiz/🎯 Quiz:https://www.passthemsra.com/quizzes/benign-positional-paroxysmal-vertigo/🎓 Full Course:https://www.passthemsra.com/courses/ent-for-the-msra/#MSRA #MSRARevision #MSRATextbook #MSRAQuiz #MSRAQuestionBank #MSRAFlashcards #MSRAQandANotes #MSRAAccordions #MultiSpecialityRecruitmentAssessment #MSRAOnlineRevision #MSRARevisionWebsite #ENT #BenignParoxysmalPositionalVertigo #BPPV