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neuro - yr 2 > acute cases of vertigo > Flashcards

acute cases of vertigo Flashcards

1
Q

define dizziness *

A

an illusion of self- and/or env motion

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2
Q

define vertigo *

A

illusory selfmotion which is spinning in nature

sibset of dizzyness

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3
Q

define oscillopsia *

A

visual world motion - because you lose the vestibulo-ocular reflex, so world wobbles when move head, becasue eyes dont move and stabalise the image

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4
Q

recogise how oscillopsia differs from vertigo *

A

vertigo is present even with one’s eyes shut

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5
Q

describe the vestibulo-ocular reflex *

A

stabalise the gaze in space - latency of 5-10ms

semicircular canals detect angular accelaration

accelorometer detect linear accelaration an tilt

when make a saccade movement - brain knows where you are moving to so the vision is suppressed = dont see world move

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6
Q

define nystagmus *

A

seeing the world move

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7
Q

what is evidence that the brain controls dizzyness et c

A

when stimultated :

low current = feeling of gentle rocking of self

high current - feeling of violent spinning of self and room

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8
Q

what are the causes of emergancy room vertigo

A

BPPV

vestiblar neuritis caused by bell’s palsy = vertigo, nystagmis, clumsiness - self limitng over a week

migrainous vertigo

stroke

mixed (syncope, anxiety)

meniere’s

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9
Q

what do you have to rule out when you see acute vertigo

A

presyncope

pul emb

cardiac dysrhythmia

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10
Q

what are the core eye examinations for acute vertigo *

A

cover

gaze

vestibulo-ocular reflex

hallpike

fundoscopy

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11
Q

describe fundoscopy

A

look at retina - check position of the disc and macula

is it spontaneousnystagmus

what is the effect of visual fixation on nystagmus

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12
Q

what are the core examinations for ears *

A

otoscopy

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13
Q

what are the core examinations for legs *

A

gait

tandem

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14
Q

describe the ear examination

A

hearing in complaint

otoscopy - only really useful with herpes - see vesicles

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15
Q

how can herpes cause dizzyness

A

infection go through temporal bone ad damage the vestibular nerve

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16
Q

treatment of posterior canal BPPV

A

epley manouver - allow fre floating particles of affected canal back to utricle so they dont stimulate the capula

semont - repositions the canaliths

17
Q

what does BPPV stand for *

A

benign paroxysmal positional vertigo

18
Q

what is the diagosis for BPPV

A

hallpike manoever - turn head 45 degrees, then lie back on bed quickly - head hangling slightly off- this makes crystals in SCC canals move = feeling of vertigo

19
Q

describe the symptoms of vestiubular neuritis *

A

subacute onset - minutes-hours

continuous vertigo

obvious vestbular nystagmus

positiv ehead impulse test

normal gait

20
Q

treatment of vestibular neuritis *

A

vestibular sedatives for 24-36hrs

mobilise at day 2-3

treat any BPPV pr migraine

21
Q

what are red flags *

A

headache

gait ataxia - may be only non-vertiginous manifestation of cerebellar stroke

hyperacute onset - suggests vasscular origin

vertigo and hearing loss - anterior inferior cerebral artery or urgent ENT problem

prolongued symptoms >4days - floor off 4th ventricle problem

22
Q

acute vestibuloar migraine signs

A

history of migraine

can have acute vertigo w/o prominant headache

recurrent

23
Q

what is assessed in a leg examination *

A

gait - narrow based

tandem walking - count how many mistakes oput of 10 tandem steps

romberg - see if eye closure effects balance, can they maintain balance >20s w/o vision

24
Q

what are the signs of bppv *

A

positional - ie lying back in bed because couldnt be postural hypertension

brief - seconds

25
Q

signs of cerebellar stroke *

A

thunderclap onset vertigo - embolic because of valsalva, afib or dissection (when neck pain/trauma)

poor balance, unable to walk or sit

headache

red flags - gait problems, hearing loss, prologued symptoms

26
Q

causes of positional nystagmus

A

either BPPV or central

27
Q

what is latency of nystagmus *

A

time for onset

28
Q

what is fatiguability of nystagmus *

A

lessening of the response with repition of the manouver

29
Q

what happens to the threshold for vestibular motion in people with acute traumatic brain injuries in comparison to controls

A

larger range, generally much higher

30
Q

how can the aTBI increase the thresold for vertigo

A

networks in the brain that are involved in vertigo are damaged

neuro - yr 2 (24 decks)

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