Balance Disorders

Question 1

Name the 3 main balance disorders

Answer 1

Labyrinthitis
BPPV
Menieres Disease

Question 2

Cause of labyrinthitis

Answer 2

An upper respiratory tract infection which affects cochlea and vestibular apparatus

Question 3

Cause of BPPV

Answer 3

Crystals form in the fluid in a VA, so they brush past the stereocilia even when patient is still. This activates the APs and causes vertigo

Question 4

Cause of Menieres Disease

Answer 4

Associated with a change in fluid volume within parts of the cochlea and vestibular apparatus, but the cause or causes are still unknown.

Question 5

Explain the difference in presentation between the 3 disorders

Answer 5

Labyrinthitis - hearing loss and vertigo. Associated with infection symptoms

BPPV - only vertigo. Episodes last seconds

Menieres - vertigo, hearing loss, tinitus and aural fullness. Episodes last much longer

Question 6

How is BPPV managed

Answer 6

Most people recover over several weeks

There are manoeuvres we can do to dislodge crystals - Epley manoeuvre

Question 7

Investigations for BPPV

Answer 7

The Dix-Hallpike manoeuvre

Question 8

Management of Menieres disease

Answer 8

• prophylactic betahistine
• prochlorperazine