Home management of BPPV

Benign positional vertigo is a condition in which a person develops a sudden sensation of spinning, usually when moving the head. It is the most common cause of vertigo. here is a good article to read :http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002393/

I find these diagrams very useful for patients with BPPV to treat themselves at home. They are simple to follow and either option is useful.

·    Modified Epley Procedure THIS is for left ear benign paroxysmal positional vertigo. For right ear, start with the head turned to the right and perform in opposite direction.  1. Start by sitting on a bed with your head turned 45 degrees to the left. Place a pillow behind you so that on lying back it will be under your shoulders.  2. Lie back quickly with your shoulders on the pillow, neck extended and head resting on the bed. In this position, the affected (left) ear is underneath. Wait for 30 seconds.  3. Turn your head 90 degrees to the right (without raising it) and wait again for 30 seconds.   4. Turn your body and head another 90 degrees to the right and wait for another 30 seconds.  5. Sit up on the right side. Repeat this three times daily until you are free from positional vertigo for 24 hours.   Source: A. Radtke et al, Self-treatment of benign paroxysmal positional vertigo: Semont maneuver vs Epley procedure, Neurology 2004, 63:150-152    Modified Semont Manoeuvre THIS is for left ear benign paroxysmal positional vertigo. For right ear, start with the head turned to the left and perform in opposite direction.  1. Sit upright on a bed with your head turned 45 degrees toward the right ear.  2. Drop quickly to the left side, so that your head touches the bed behind your left ear. Wait 30 seconds.  3. Move head and trunk in a swift movement toward the other side without stopping in the upright position, so that your head comes to rest on the right side of your forehead. Wait again for 30 seconds.  4. Sit up again. Repeat this three times daily until you are free from positional vertigo for 24 hours.  You may experience bad vertigo, as well as nausea and vomiting, during the first few times on these exercises. Ask your doctor if you need medications or anti-vomiting drugs.    Source: A. Radtke et al, Self-treatment of benign paroxysmal positional vertigo: Semont maneuver vs Epley procedure, Neurology 2004, 63:150-152

Dental disease in Northland

Dental infection and secondary neck abscesses are regrettably very common emergency admission for our department. Northland experiences some of the highest dental disease rates in New Zealand. For the last year the hospital dental services are available 24hrs. a day for managing acute abscesses and we are available for extensive neck involvement.

This picture is a case I was involved with. The sad thing is that this is largely a preventable disease. It interested me that this man had never brushed his teeth for as long as he could remember.
When we see patients with other problems we will always discuss and educate them about smoking, but how often do we comment on their teeth and the importance of prevention of dental disease. I appreciate the big factor is cost, but I would encourage all of us to spend time in our consultation to look and advise on the patients teeth. For more reading go to Oral health for all Northlanders