NR 576 Week 7 Assignment; Article for Clinical Practice Guidelines Presentation - Benign Paroxysmal Positional Vertigo

10 97 68 S2 Otolaryngology–Head and Neck Surgery 156(3S) 17, 20 17, S3, Do the absence of additional signs and/or symptoms inconsistent wn  New algorithm to clarify decision making and loa with BPPV that warrant imaging, (2) vestibular testing for a de action statement relationships d patient who meets diagnostic criteria for BPPV in the absence fro  New recommendation regarding canalith reposition- m of additional vestibular signs and/or symptoms inconsistent htt ing postprocedural restrictions ps: with BPPV that warrant testing, and (3) routinely treating //a  Expansion of the recommendations regarding radio- ao- BPPV with vestibular suppressant medications such as antihis- hn graphic and vestibular testing sfj tamines and/or benzodiazepines. The guideline update group our  Removal of the “no recommendation” for audiomet- nal provided the options that clinicians may offer (1) observation s.o ric testing nli with follow-up as initial management for patients with nel  Addition of a diagnostic and treatment visual algo- ibr BPPV and (2) vestibular rehabilitation, either self- ary rithm .wi administered or with a clinician, in the treatment of BPPV. ley .co m/ doi /10 Keywords Introduction .11 77/ A primary complaint of dizziness accounts for 5.6 million 01 benign paroxysmal positional vertigo, BPPV 94 clinic visits in the United States per year, and between 17% 59 98 Received October 19, 2016; revised November 17, 2016; accepted and 42% of patients with vertigo ultimately receive a diagno- 16 68 December 29, 2016. sis of benign paroxysmal positional vertigo (BPPV).2-4 BPPV 96 67, Wi is a form of positional vertigo. ley On Differences from Prior Guideline lin e This clinical practice guideline is as an update and replace-  Vertigo is defined as an illusory sensation of motion Li bra ment for an earlier guideline published in 2008 by the of either the self or the surroundings in the absence ry on American Academy of Otolaryngology—Head and Neck of true motion. [17 /10 1  Positional vertigo is defined as a spinning sensa- /20 Surgery Foundation (AAO-HNSF). An update was necessi- 23] tated by new primary studies and systematic reviews that tion produced by changes in head position relative . Se to gravity. e might suggest a need for modifying clinically important rec- the  BPPV is defined as a disorder of the inner ear char- Te ommendations. Changes in content and methodology from rm acterized by repeated episodes of positional vertigo s the prior guideline include the following: an d (Table 1). Co ndi tio  Addition of a patient advocate to the guideline ns Traditionally, the terms “benign” and “paroxysmal” have (ht devel- opment group tps been used to characterize this particular form of positional ://o  New evidence from 2 clinical practice guidelines, 20 nli vertigo. In this context, the descriptor benign historically nel systematic reviews, and 27 randomized controlled ibr implies that BPPV was a form of positional vertigo not due ary trials (RCTs) .wi to any serious central nervous system (CNS) disorder and ley  Emphasis on patient