[16] Vertigo Flashcards
What is dizziness?
A general, non-specific term to indicate a sense of disorientation
Is vertigo the same as dizziness?
No, vertigo is a type of dizziness
What is vertigo?
A false sensation that oneself or the surroundings are moving or spinning
What is vertigo usually accompanied by?
- Nausea
- Loss of balance
What is vertigo the result of?
Mismatch between the vestibular, visual and somatosensory systems
What groups can the causes of vertigo be subdivided into?
- Central
- Peripheral
What structures can be affected in central vertigo?
- Cerebral cortex
- Cerebellum
- Brainstem
What structures can be involved in peripheral vertigo?
- Vestibular labyrinth
- Vesticular nerve
- Semicircular canals
What are the central causes of vertigo?
- Cerebrovascular disease
- Migraine
- MS
- Acoustic neuroma
- Diplopia
- Alcohol intoxication
What are the peripheral causes of vertigo?
- Viral labyrinthitis
- Vestibular neuritis
- BPPV
- Meniere’s disease
- Motion sickness
- Ototoxicitiy
- Herpes zoster (Ramsay Hunt)
What drug can cause ototoxicity?
Gentamicin
What does BPPV stand for?
Benign paroxysmal positional vertigo
What are the risk factors for vertigo?
- Older age
- Past episodes of dizziness
What sensation is experienced in vertigo?
Spinning whilst stationary
What other symptoms is vertigo commonly associated with?
- Nausea
- Vomiting
- Unsteadiness
- Falls
- Changes to person’s thought
- Difficulty walking
In what time frame can the symptoms of vertigo present?
- Insidious (persistent)
- Sudden (episodic)
What investigations are performed in primary care for vertigo?
Usually none
What investigatiosn can be performed for vertigo in secondary care?
- Audiometry
- Dix-Hallpike manoeuvre
- Electronystagmography
- CT or MRI
- EEG
- LP
- Syphilis serology
What is audiometry used for when testing for vertigo?
Assessing cochlear function
What is Dix-Hallpike used for in assessing vertigo?
Testing for BPPV
What can a CT or MRI be used to look for in a patient with vertigo?
Neurological causes
Why may an EEG be useful in assessing a patient with vertigo?
To look for epilepsy
What can an LP look for in a patient with vertigo?
MS
What are the differentials for vertigo?
- Postural hypotension
- Pre-syncope
- Non-specific dizziness
- Disequilibrium
