International Journal of Otorhinolaryngology and Head and Neck Surgery | April 2020 | Vol 6 | Issue 4 Page 612 International Journal of Otorhinolaryngology and Head and Neck Surgery Munjal M et al. Int J Otorhinolaryngol Head Neck Surg. 2020 Apr;6(4):612-615 http://www.ijorl.com pISSN 2454-5929 | eISSN 2454-5937 Original Research Article A retrospective study on benign paraoxysmal positional vertigo in a tertiary health care facility of North India Manish Munjal, Harsimran Bhatti*, Japneet Kaur, Porshia Rishi, Shubam Munjal INTRODUCTION Vertigo or disequilibrium is an incapacitating entity, with an underlying pathology ranging from a benign to life threatening intracranial space occupying lesion. Family physicians, cardiologists, ophthalmologists, neurologists, neurosurgeons and otolaryngologists are likely to be consulted, either at primary or referral level. 1 Benign episodic spells of vertigo lasting for a few seconds on a particular position of the head causes anxiety, fear and loss of concentration and thereby effective working hours. This entity being the commonest, in the panicky vertiginous patients presenting in our outpatient clinics needs adequate addressal for proper management and relief of symptoms. The most important step required while addressing this entity is clinical history. 2,3 Otoconial ‘truancy’ or ‘release’ consequent to viral infection or head injury and a ‘ampullary bounce’ on the neuro-epithelium ‘of the posterior semi-circular canal is the microscopic level pathophysiology. A quick 45 degree head extension ‘the Dix Hallpike ‘positioning test, precipitates a symptomatic spin vertigo with signs of torsional nystagmus, on the involved side. Head-torso manoeuvre, Epley and Semont manoeuvres helps to reverse the trajectory of the otoconia and thereby propel, them from the effected ampulla through the semi- circular ducts into the vestibule via the non-ampullated end or the crus commune. The vertiginous patient walks out of the clinic, unsupported and relieved. However, a repeat procedure maybe needed as a few otoconia creep back. Therefore, with the evolution of highly effective ABSTRACT Background: Benign paraoxysmal positional vertigo (BPPV) has been attributed to be one of the commonest causes of vertigo presenting to the clinician. However, this often remains undiagnosed and undertreated, epidemiology remaining an underexplored territory for this disorder. Methods: A study was carried out at outpatient clinic, Ear Nose Throat, Head and Neck services, Dayanand Medical College and Hospital, Punjab over a period of one year from 1 st January to 31 st December 2018. Based upon history, detailed otological examination, and Dix-Hallpike testing, 374 patients were evaluated for benign paroxysmal positional vertigo presenting with complaint of vertigo and dizziness in the vertigo clinic and were treated with Epley’s maneuver. Results: Out of 374 patients evaluated, 79 patients were diagnosed as BPPV and underwent office management in the form of Epley’s maneuver. Conclusions: This study helps in effective team approach among practitioners and clinicians in the hospital for referring vertigo cases to ENT OPD for effective management of vertigo. Keywords: Vertigo, Epley’s maneuver, Benign paraoxysmal positional vertigo, Positional testing Department of ENT, Dayanand Medical College and Hospital, Ludhiana, Punjab, India Received: 09 July 2019 Revised: 05 March 2020 Accepted: 06 March 2020 *Correspondence: Dr. Harsimran Bhatti, E-mail: harsimranbhatti80@gmall.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20201280