Perceived disability among patients with BPPV is usually assessed using standardised questionnaires, the most common being the Dizziness Handicap Inventory (DHI), 13 for which several abbreviated versions have been created. 8, 9 Vertigo increases the risk of falls, 10 particularly among elderly patients, 11 and also causes psychological symptoms that can lead patients to avoid certain everyday situations. Many patients with BPPV experience impaired physical and functional performance and the condition can also have an effect on family and social life. 6 This form of BPPV is known as subjective BPPV (S-BPPV) and it accounts for around 11.5–48% of all cases. According to some authors, however, the DHT may also be considered positive if the patient experiences symptoms without nystagmus. This form of BPPV is known as objective BPPV (O-BPPV). 5 The DHT is considered to be positive when it causes both vertigo and nystagmus. Pc-BBPV can be diagnosed with relative ease in primary care, as a targeted history, a basic physical examination, and performance of the Dix–Hallpike test (DHT) are sufficient to establish a diagnosis. 3 Posterior canal BPPV (pc-BPPV) is the most common variant and accounts for 60–90% of all cases. 2 According to one systematic review, between 4.3% and 39.5% of patients seen in primary care for dizziness had BPPV. Benign paroxysmal positional vertigo (BPPV), the most frequent cause of vertigo, has an annual incidence ranging from 10.7 to 140 cases per 100 000 inhabitants 1 and a lifetime prevalence of 2.4%.
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