4 - ENT - Vertigo - dizziness, Nystagmus and Romberg's

Question 1

define dizziness

Answer 1

non specific complaint - may encompass vertigo, dysequilibrium, light headedness ,ataxia, displopia

Question 2

define vertigo - may be accompanied by?

Answer 2

the illusion of movement

may get N+V, pallor, diarrhoea

Question 3

CV causes of dizziness

Answer 3

arrhythmias, hypotension, vaso-vagal attacks (fainting when seeing eg blood)

Question 4

what is nystagmus and its 2 types

Answer 4

involuntary to and fro movements of the eyes

fast phase - pathological
slow phase - corrective

Question 5

what usually causes horizontal nystagmus

what may cause vertical or horizontal nystagmus

Answer 5

peripheral vestibulopathy

central disease

Question 6

direction of nystagmus

• central disease?
• peripheral disease?

(irritative lesion?)

Answer 6

• central - fast phase towards lesion
• peripheral - fast phase away from lesion

irritative = towards lesion

Question 7

describe the 3rd degree of nystagmus

Answer 7

• in acute phase - nystagmus while gaze is ipsilateral, straight ahead and contralateral

Question 8

describe the 2nd degree of nystagmus

Answer 8

2-3 days later - nystagmus straight ahead and contralateral

Question 9

describe the 1st degree of nystagmus

Answer 9

a few weeks later , nystagmus only contralateral

Question 10

what premise is Rombergs based on

Answer 10

balance requires three functions - vision, proprioception, vestibular function

Question 11

Rombergs - how? shows?

Answer 11

pt stand still, arms by side, then close eyes for a minute

swaying/falling = +ve - indicates proprioceptive/vestibular dysfunction