Benign Positional Vertigo

Question 0

Peripheral versus central vertigo: dysfunction of?

Answer 0

Caused by labyrinthine apparatus or vestibular nerve

versus

brainstem or cerebellum

Question 1

Best treatment for benign positional vertigo?

Answer 1

Dix-Hallpike maneuver (to dx BPV)

Question 2

Differential diagnosis for dizziness?

Answer 2

1. Presyncope
2. Dysequilibrium
3. Vertigo

Question 3

Peripheral versus central vertigo: Duration and deficits?

Answer 3

Intermittent but recurrent with hearing loss/tinnitus but no other neurologic deficits

Chronic with neurologic deficits (palsies, weakness, dysarthria) but no tinnitus or hearing loss

Question 4

Causes of presyncope?

Answer 4

Vasovegal, orthostatic hypotension, arrhythmias

Question 5

Disequilibrium can be caused by these drugs?

Answer 5

Antihypertensives, antidepressants, anticholinergics

Question 6

Peripheral versus central vertigo: Urgency of treatment?

Answer 6

Central causes can suggest hemorrhage or infarction and can be life-threatening

Peripheral causes can be handled as an outpatient

Question 7

Positive Dix-Hallpike maneuver it?

Answer 7

Nystagmus occurs 5 to 10 seconds after moving head

Question 8

Treatment for benign paroxysmal positional vertigo?

Answer 8

1. Meclizine or diphenhydramine (anti-cholinergics)
2. Benzodiazepines
3. Epley maneuver

Question 9

Meniere disease?

Answer 9

Severe vertigo with tinnitus, hearing loss, and sensation of ear fullness

Question 10

Vertebrobasilar insufficiency?

Answer 10

Vertigo with diplopia, dysarthria, numbness