BPPV, Meniere's and neuronitis/labyrinthitis

Question 1

central causes of vertigo

Answer 1

stroke

MS

Question 2

vertigo is the symptom. what is the sign?

Answer 2

nystagmus

Question 3

hx BPPV

Answer 3

turns in bed, sudden vertigo lasting SECONDS

no other sx

Question 4

BPPV caused by

Answer 4

misplaced otoconia in the middle ear (usually in the posterior semicircular canal)

Question 5

dx of BPPV

Answer 5

dix hallpike test results in nystagmus (+rule out other causes)

Question 6

rx BPPV acute and maintenance

Answer 6

epley manoeuvre
bradt daroff exercises for maintenance

nb beta histines make it worse

Question 7

triad in meniere’s + other sx

Answer 7

sensorinueral hearing loss, tinnitus and vertigo.
usually unilateral
nystagmus
feel rly unwell. lasts 24 h
NB most are left with some degree of hearing loss

Question 8

rx meniere’s

Answer 8

low salt diet
acute - prochloperazine
prevention - beta histine
surgical - gromets, labyrinthectomy
must inform DVLA

Question 9

sx vestibular neuronitis/labyrinthitis

Answer 9

follows URTI
acute DEBILITATING vertigo days to weeks. in bed, rly poorly

hearing loss in labyrinthitis. No hearing loss (by definition) in Neuronitis

Question 10

rx vestibular neuronitis/labyrinthitis

Answer 10

prochloperazine in acute phase. stopped after a few days bc delays recovery.
after acute phase - mobilisation and 2x daily vestibular rehab exercises

Question 11

dizzyness on extending neck =

Answer 11

verterobasilar ischaemia