Balance problems Flashcards
in vertigo, duration is key. what is the cause?
- seconds
- hours
- days
- variable
BPPV is seconds
Menieres is hours
Vestibular neuritis is days
migraine associated vertigo is variable
classic BPPV?
seconds of vertigo on specific movements
- eg turning in bed
- eg bending forwards
classic vesti neuritis?
1st episode was severe, for hours + nausea + vomiting
generally not any HL or pain
classic vestibular migraine?
photophobia when dizzy!
classic menieres?
on the “affected side”….
ear “fullness” + hearing loss + tinnitus
> 20 mins - hours
classic labrinythitis ?
need 1 episode of documented SNHL
also affects balance
may have pain with infection (viral / bacterial)
what causes BPPV?
- generally
- what actually happens
idiopathic / trauma / surgery
otolith material (crystals) being displaced …. from utricle –> (posterior) SCCs
they trigger SCC hair cells to tell the head there is movement occuring
what can BPPV get confused with?
Vertebrobasilar insufficiency
but this also has visual + weakness + numbness
main manoeuvre for BPPV
Epley’s
what is the treatment for Vestibular neuronitis / labrinthitis?
- medical
- rehab technique
medical = vestibular sedative for acute symptomatic relief
- eg Benzodiazepine
then you need to keep doing Vestibulo-ocular reflex (VOR) exercises
prognosis for attack of vestibular neuronitis/ labrintythitis
3 days in bed
3 weeks off work
3 months off balance
medical options for management of Meniere’s disease
- vestibular sedative
- intratympanic steroid / gentamicin for vertigo
- tinnitus therapy
non-medical options for management of Meniere’s
hearing loss? - use aids
grommet / meniette (?)
surgery
prevention - eg. avoid alcohol
what is more common in vertigo migraines?
a) hearing loss
b) phonophobia
c) tinnitus
b = phonophobia is common with migraines + vertigo
fun fact: so it motion sickness :)
name a few things that can cause non-vestibular dizziness
cardiac - postural hypotension + arrthymias
visual - cataracts
stress, migraines, MS
