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Assessment for benign paroxysmal positional vertigo in medical patients admitted with falls in a district general
Joel Abbott1, Sylvia Tomassen2, Laura Lane2
1Wrexham Maelor Hospital, Wrexham, UK cameronabbott@doctors.org.uk.
Abstract:
Having benign paroxysmal positional vertigo (BPPV) puts patients at a significantly higher risk of falling. It is poorly recognised and diagnosis is frequently delayed. BPPV has been studied in outpatient settings, but there have been no studies looking at the prevalence in patients admitted with falls. This study aims to establish how common BPPV is in these patients.For a 4-month period, patients admitted on an unselected medical take were screened for an admission precipitated by a fall. Patients who consented were assessed for BPPV using the Dix-Hallpike manoeuvre. Patients who tested positive were treated using the Epley manoeuvre. The assessments were carried out by specialist physiotherapists who were experienced at assessing and diagnosing patients with peripheral vestibular disorders. Out of the 111 patients initially identified, 37 (33%) were considered to be appropriate and consented to be part of the study. Of these, 20 patients (54%) had a positive Dix-Hallpike manoeuvre.Of the patients included in the study, over half tested positive for BPPV. This merits further study. Potentially, there is a proportion of patients admitted with falls who have an easily treatable contributing factor that is not being identified with standard practice.
Insights
Benign paroxysmal positional vertigo (BPPV) significantly increases fall risk. Over half of patients admitted for falls were diagnosed with BPPV, indicating a common, treatable cause often missed in standard care.
Area of Science:
- Geriatric Medicine
- Neurology
- Otolaryngology
Background:
- Benign paroxysmal positional vertigo (BPPV) is a leading cause of dizziness and increases fall risk.
- BPPV is often underdiagnosed, particularly in hospitalized patients presenting with falls.
- Limited research exists on BPPV prevalence among patients admitted due to falls.
Purpose of the Study:
- To determine the prevalence of BPPV in patients admitted to the hospital following a fall.
- To assess the diagnostic yield of specific maneuvers for BPPV in this patient population.
Main Methods:
- Prospective screening of patients admitted for falls over a 4-month period.
- Assessment using the Dix-Hallpike maneuver by experienced physiotherapists for BPPV diagnosis.
- Treatment with the Epley maneuver for positive cases.
Main Results:
- 37 out of 111 screened patients (33%) were included in the study.
- 20 out of 37 included patients (54%) tested positive for BPPV.
- A high prevalence of BPPV was observed in patients admitted with falls.
Conclusions:
- Over half of the studied patients admitted for falls had BPPV.
- BPPV may be an unrecognized, treatable contributor to falls in hospitalized patients.
- Further investigation is warranted to integrate BPPV screening into routine fall assessment.
