Benign paroxysmal positional vertigo among elderly patients in primary health care

Background: Dizziness influences well-being in old age, and benign paroxysmal positional vertigo (BPPV) is a common cause. The condition is diagnosed using the Hallpike maneuver and treated by the particle-repositioning maneuver or habituation exercises. Objective: To identify patients with BPPV among a variety of diagnoses represented by the ICD-10 diagnosis R42 in people 65 aged years and older who visited primary health care because of vertigo and dizziness. Methods: Searches were performed in the computerized medical records of 6 different health care centers over the period of 1 year for the ICD-10 diagnosis R42 and the age group 65 years and older. Letters were sent to the patients identified with an invitation for assessment and physical examination by a physiotherapist. Thirty-eight patients responded to the letter and were included in the study. All patients were assessed by physical examination including the Hallpike maneuver. Results: The study group included 13 men and 25 women, 65-94 (median 83) years of age. After physical examination, 15 patients were found to have BPPV (confidence interval 24-55%). Conclusion: In this study, 2 of 5 of the patients with ICD-10 diagnosis R42 (dizziness and giddiness) had BPPV. BPPV is probably an underestimated cause of dizziness/vertigo among elderly patients in primary health care.