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Neuroscience & Mental Health Y2 > A Scientific and Clinical Approach to Acute Vertigo > Flashcards

A Scientific and Clinical Approach to Acute Vertigo Flashcards

1
Q

what is Vestibular-motion perception

A

sensation of motion- of self or environment

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2
Q

What is seeing environmental motion known as

A

Oscillopsia

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3
Q

Oscillopsia is…

A

Seeing environmental motion

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4
Q

Oscillopsia indicates…

A

nystagmus

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5
Q

Vertigo is…

A

Sensation of spinning of self and environment

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6
Q

2 types of Vertigo?

A

LOW current: Gentle rocking sensation

HIGH current: Violent spinning of self and room

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7
Q

What is dizziness defined as

A

see the world moving

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8
Q

Why do people feel like they’re still when in reality they’re on a moving chair

A

they begin to feel still because the fluid in the semi-circular canals moves with the chair

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9
Q

Acutely symptoms [may/may not] follow signs

A

may

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10
Q

Chronically symptoms [may/may not] follow signs

A

may not

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11
Q

Where is the area in the brain that relates to ability to suppress dizziness

A

Vestibular cerebellum

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12
Q

Phrases that could be used by patients to describe vertigo:

A

floating, spinning like a merry-go-round, rocking like a boat

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13
Q

Common causes of vertigo? (5)

A 
BPPV - Benign paroxysmal positional vertigo 
Vestibular neuritis
Stroke
Menieres
Anxiety
Syncopy
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14
Q

Parts of the vestibular system? (6)

A 
Cerebral cortex
Thalamus
Vestibular cerebellum
The peripheral vestibular organ
Ponto-medullary junction
Spinal cord
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15
Q

First 3 things you do in A&E with a patient with vertigo?

A

you want to exclude presyncope, pulmonary embolism and cardiac arrhythmia so you would check postural BP, arterial saturation and do an ECG

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16
Q

what do we do when examining for acute vertigo? (3)

A

Gaze
VOR - vestibular ocular reflex
Hallpike
Opthalmoscopy

17
Q

What is the result of a VOR test

A

Head impulse test assesses vestibular-ocular reflex- the deficient side will lose fixation on you and then undergo a re-fixation saccade

18
Q

BPPV causes? (2)

A

 Positional cause of vertigo- lying down

 Torsional nystagmus (pulling on the skin around the eye causes nystagmus)

19
Q

Describe a VOR test

A

Get patient to focus on you then twist head to right and left and see if they are still looking at you

20
Q

Central problems cause what direction torsional nystagmus?

A

downbeat

21
Q

Cure for BPPV

A
  • Right hallpike and semont (basically pull the person’s torso over to the right very quickly while they sit, and check for nystagmus, and treat by then flipping the person over the other side very quickly- semont- this is curative)
22
Q

VESTIBULAR NEURITIS onset?

A

Minutes to hours

23
Q

VESTIBULAR NEURITIS symptoms?

A

 Continuous vertigo
 Obvious ‘vestibular’ nystagmus
 Positive head impulse test
 Normal gait

24
Q

VESTIBULAR NEURITIS treatment?

A

Do not medicate- should resolve itself but medication can worsen its

25
Q

Red flags of patients presenting with acute vertigo? (6)

A 
Headache
Gait Ataxia
Hyperacute Onset:
 Vertigo + Hearing Loss
Prolonged Symptoms (>4 days):
26
Q

headache and vertigo could be due to…

A

posterior circulation stroke

27
Q

Hyperacute Onset of vertigo could be due to…

A

suggests vascular origin

28
Q

Vertigo + Hearing Loss could be due to…

A

AICA (anterior inferior cerebellar artery) or urgent ENT problem

29
Q

Prolonged Symptoms of vertigo could be due to…

A

Floor of 4th ventricle problem

30
Q

Gait Ataxia of vertigo could be due to…

A

non-vertigonous manifestation of cerebellar strokes

31
Q

MIGRAINOUS VERTIGO signs and method of diagnosis? (3)

A

 History of migraine
 Acute vertigo without headache
 Diagnosis of exclusion- main differential diagnosis is cerebellar stroke

32
Q

CEREBELLAR STROKE signs and method of diagnosis? (3)

A

 Thunderclap onset vertigo
 Difficulty walking
 Headache

33
Q

positive HEAD IMPULSE TEST suggests damage where?

A

`peripherally

34
Q

positive gait ataxia suggests damage where?

A

centrally

35
Q

vertigo is a [symptom/diagnosis]

A

symptom

36
Q

what is RAMSEY HUNT SYNDROME? central or peripheral?

A

peripheral
 Facial weakness
 Rash- re-activation of varicella zoster
 Complete loss of hearing/vestibular function

Neuroscience & Mental Health Y2 (18 decks)

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