Neurol. praxi. 2025;26(4):293-296 | DOI: 10.36290/neu.2025.033

Benign paroxysmal positional vertigo in the elderly

doc. PhDr. Ondřej Čakrt, Ph.D., Mgr. Klára Kučerová, Ph.D.

Klinika rehabilitace a tělovýchovného lékařství 2. LF UK a FN Motol, Praha

Benign paroxysmal positional vertigo (BPPV) is the most common vestibular disorder and its incidence increases significantly with age. In the elderly, BPPV often manifests differently than in younger patients - rather than the typical positional vertigo, a feeling of uncertainty and postural instability dominates, often leading to misdiagnosis and delayed treatment. The basis of treatment is repositioning manoeuvres, which have a success rate of up to 80 % when performed correctly, but in the elderly it is often necessary to modify them due to associated limitations and to take into account the occurrence of residual instability. In practice, the main problem is the lack of implementation of diagnostic and treatment procedures, with only one third of patients undergoing diagnostic manoeuvres and receiving adequate treatment. Early diagnosis and implementation of repositioning manoeuvres are crucial for successful treatment. In patients with residual instability, we indicate follow-up rehabilitation, which should take place over 4-6 weeks.

Keywords: vestibular system, vertigo, gait disorders, postural instability, repositioning manoeuvres, residual vertigo.

Received: February 3, 2025; Revised: April 3, 2025; Accepted: April 3, 2025; Prepublished online: April 3, 2025; Published: September 29, 2025  Show citation