8.24 General Limb Pain 3 Flashcards
What are the pathological neck conditions?
- cervical myelopathy
- neoplastic condition
- cervical ligamentous instability
- vertebral artery insufficiency
cervical myelopathies: What are the common s/s?
- sensory disturbance of hands
- muscle wasting of hands
- unsteady gait
- Hoffman’s reflex
- hyperreflexia
- b/b issues
- multi-segmental weakness and sensory changes
neoplastic conditions: things to consider
- hx of cancer
- unexplained weight loss
- constant pain
- night pain
cervical ligamentous instability: often get c/o these types of headaches
occipital
What might a cervical ligamentous instability look like?
cervical myelopathy
What else can go on in the occipital region with cervical ligamentous instability?
occipital numbness
What is associated with vertebral artery insufficiency?
- 5 D’s
- cranial nerve signs
What are the 5 D’s?
- dizziness
- dysphasia
- dysarthria
- diplopia
- drop attacks
categories of dizziness
- vertigo and nystagmus
- dysequilibrium
- presyncope
- non-specific psychophysiologic
vertigo and nystagmus gives the sensation of
spinning
dysequilibrium
unsteadiness or imbalance without vertigo
presyncope
near-fainting or lightheadedness
If a pt has fullness in the ears, tinnitus, and hearing loss associated with dizziness, what would you think is the cause?
vertigo and nystagmus
If the pt has somatosensory, visual, decreased reaction time, lack of corrective ROM, an aging brain, or cerebellar issues associated with dizziness, what would you think is the issue?
dysequilibrium
Which categories of dizziness are associated with pallor, nausea, vomiting, diaphoresis?
- presyncope
- vertigo and nystagmus
What are some of the s/s of non-specific psychophysiologic dizziness?
- floating
- rocking or swimming sensations
- removed from body
- giddiness
What may cause presyncope?
- cardiovascular
- metabolic
- vasovagal
- medication
- stress
What may cause non-specific psychophysiologic dizziness?
- anxiety
- motion sickness
- pain disorders
- personality disorders
- depression
- agoraphobia
What are the likely causes of dizziness in infants/toddlers?
- BPPV and vestibular migraine
- vestibular neuritis
- brainstem or cerebellar tumor
- TBI
Children 0-4 y/o are at a high risk for
TBI
Percentage of cases where infant/toddler dizzines is caused by BPPV and vestibular migraine
50%
What action should be taken by the provider if an infant/toddler has dizziness? Why?
like need an MRI - prevalence of brain tumor in children
possible causes of dizziness in children and adolescents
- vertiginous migraine
- BPPV
- vestibular neuritis-ear infection
- anxiety
- orthostatic hypotension
- concussion
- seizure, syncope, nonspecific
percentage of cases that cause dizziness in children and adolescents: vertiginous migraine
39%
