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
signs of cerebellar stroke \*
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
causes of positional nystagmus
either BPPV or central
27
what is latency of nystagmus \*
time for onset
28
what is fatiguability of nystagmus \*
lessening of the response with repition of the manouver
29
what happens to the threshold for vestibular motion in people with acute traumatic brain injuries in comparison to controls
larger range, generally much higher
30
how can the aTBI increase the thresold for vertigo
networks in the brain that are involved in vertigo are damaged