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Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (BPPV)

Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (BPPV)

This guideline was published as a supplement in the March 2017 issue of Otolaryngology—Head and Neck Surgery.

The primary purposes of this guideline are to improve the quality of care and outcomes for BPPV by improving the accurate and efficient diagnosis of BPPV, reducing the inappropriate use of vestibular suppressant medications, decreasing the inappropriate use of ancillary testing such as radiographic imaging, and increasing the use of appropriate therapeutic repositioning maneuvers. The guideline is intended for all clinicians who are likely to diagnose and manage patients with BPPV, and it applies to any setting in which BPPV would be identified, monitored, or managed. The target patient for the guideline is aged ≥18 years with a suspected or potential diagnosis of BPPV. The primary outcome considered in this guideline is the resolution of the symptoms associated with BPPV. Secondary outcomes considered include an increased rate of accurate diagnoses of BPPV, a more efficient return to regular activities and work, decreased use of inappropriate medications and unnecessary diagnostic tests, reduction in adverse events associated with undiagnosed or untreated BPPV. Other outcomes considered include minimizing costs in the diagnosis and treatment of BPPV, minimizing potentially unnecessary return physician visits, and maximizing the health-related quality of life of individuals afflicted with BPPV.

Update Leadership: Neil Bhattacharyya, MD (Chair), Samuel P. Gubbels, MD, FACS (Assistant Chair), Seth R. Schwartz, MD, MPH (Methodologist)

Guideline Update Group: Johnathan Edlow, MD, Hussam El-Kashlan, MD, Terry Fife, MD, Deena B. Hollingsworth, MSN, FNP-BC, CORLN, Janene M. Holmberg, PT, DPT, NCS, Katie Mahoney, Richard Roberts, PhD, Michael D. Seidman, MD, FACS, Robert Wm. Prasaad Steiner, MD, PhD, Betty Tsai, MD, Courtney C. J. Voelker, MD, PhD, Richard W. Waguespack, MD

This guideline is endorsed by: 

American Academy of Physical Medicine and Rehabilitation (AAPM&R)
American Academy of Audiology (AAA)
American Neurotology Society (ANS)
American Otological Society (AOS)
American Physical Therapy Association (APTA)
Society of Otorhinolaryngology Head-Neck Nurses (SOHN)
Triological Society
American Academy of Emergency Medicine (AAEM)
Vestibular Disorders Association (VEDA)

Affirmation of Value provided by:

American Academy of Neurology (AAN)
American Academy of Family Physicians (AAFP)


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