audiology and headache and dizzyess Flashcards
presbycusis, what is it.
age related hearing loss
reduction in higher frequencies, symmetric (less than a 15 db gap)
40-45 or older.
progressive loss.
RF: ginetics, smoking, htn, dm.
Rx: hearing aids.
discuss ototoxicity
drug induced hair loss
new reaserch is ginetic suseptibiliity to it.
loop diuretics can cause, abx can cause,
acoutsic neuroma
slow gwoing, benign
1 per 100000
asymetrical hearing loss on presentation. tinitus, dizzyness
Dx: mri of internal acoistic meatus.
Ms: surgery if v big
radio to shrink if not big
headache types
90% are primary headache syndromes
5-10% are 2’.
migrane characteristics, management + prophylaxis
hours to days gradual build.
unilateral, pulsating, mod-severe
address triggers- meals, fluids,sleep, stress.
Rx: sumatryptan 6mg subcut, 50-100oral (first line)
or 400-600 NSAIDS(ibuprofen) Or paracetamol at onset. highflow 02+ aspirin. 900mg.
prophylaxis: topiromate/ propanalol.
can use botox
features of medication overuse
daily headaches- usualy a progression from their frequent headaches to daily
tension headache
band like around head
photo or phonophobia
Rx: paracetamol/ nsaids
prophylaxis: amitryptiline.
cluster headache
men>women
autonomic features- lacramation, ptosis, rhinorrhea etc.
unilateral
custers of headaches for weeks/ months
30min-4 hours- up to 8x a day
restless
Rx: oxygen
tryptans (suma 6mg subcut)
prevention:
pred 60mg. at start at cluster.
home o2
verapamil if needed
trigeminal neuralgia
vv painful.
sudden- seconds to minuites
trigeminal distribution.
Rx: carbamazapine 100mg bd- titrate up.
need mri imaging
neuro exam normal
consequences of dizzyness + ,
12x greater likelyhood of falling. - falls most common cause of accidental death in over 75s
bppv
90% posterior canal affected. - bending down/ up activates it.
breif- last a few seconds but repetitively.
utricle- horisontal
sacule- vert
