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Old 5th May 2008, 13:24
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omniplasm
 
Join Date: Oct 2006
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labyrinthitis vs BPV

Chaps & Chapesses

Diagnosis of vertiginous disorders is an area poorly understood and poorly performed by most general practitioners. AMEs might be a bit better but I wouldn't bet on it.

The commonest misdiagnosis is confusion between labyrinthitis (which overlaps with a closely related condition called vestibular neuritis) and benign positioning vertigo (BPV). There's a lot of small print but basically BPV is vertigo only precipitated by change in head position, most commonly lying down, lasts for <60sec total vertigo even if you feel sick for longer, and after a while at rest you feel perfectly fine. Labyrinthitis is vertigo lasting for days, worse with any head movement but not completely resolving at rest, with a slow recovery over weeks to a month or three depending on severity and vestibular demands (ie you might be fine walking but in bumpy IMC with a partial panel you might as well get out and walk).

The two conditions require completely different treatments. BPV, which is really common, doesn't need drugs.

There are a number of other vestibular disorders that are less common, not detailed here. This obviously includes barotrauma which should be obvious (onset with change in pressure).

Coming back to my original point, skill in this area is really sparse and confined to a proportion only of ENTs and neurologists, few GPs and virtually no-one else. So if it matters to your professional career get a serious opinion. Often it doesn't matter - all gone long away - in which case fine. Sorry to sound discouraging and I don't usually bother interfering in this forum, but there seems to be some problems here.

For your reference I often suggest people go to emedicine for their well written reviews, and would include these:

http://www.emedicine.com/NEURO/topic411.htm

http://www.emedicine.com/emerg/TOPIC637.HTM
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