Clinical Approach to Disorders of Equilibrium (Hon) Flashcards
Balance and awareness of body position in relation to surroundings requires input from two of the following three systems:
1) Visual (to judge distance)
2) Labyrinthine (to judge acceleration and position change)
3) Proprioceptive (to judge posture)
The Romberg test is assessing what system?
Proprioceptive
What is characterized by illusion of movement of oneself or objects around self may be vestibular or neurologic in origin?
(rotational, spinning component, and is the perception of movement, either of the self or surrounding objects)
Vertigo
What may be caused by vertigo but is usually a nonvertiginous state of altered static or dynamic balance?
(Unsteadiness, imbalance, or loss of equilibrium that is often accompanied by spatial disorientation)
Disequilibrium
What is characterized by lightheadedness or send of impending loss of consciousness often due to orthostasis, arrhythmia, hyperventilation and aggravated by high temp?
Presyncope
Vertigo is due to disturbance in?
Vestibular dysfunction (semicircular canals/otoliths)
What is the most common cause of recurrent vertigo?
Benign Positional Vertigo
Benign Positional Vertigo is triggered by?
Changes in head position with respect to gravity
Which semicircular canal is most commonly affected by BPV?
Posterior
BPV is confirmed by?
Dix-Hallpike position testing
What is Vestibular Neuronitis
Spontaneous Vertigo attack that does not involve tinnitus or hearing loss and is not positional
How does Vestibular Neuronitis differ from BPV?
Vestibular Neuronitis is not triggered by positional changes
Meniere’s disease is due to?
- onset?
- sex?
- treatment?
Increase in the volume of labyrinthine endolymph because of poor absorption (endolymphatic hydrops)
- 20-50’s
- Female
- Restrict Sodium and diuretics
What are the symptoms of Meniere’s disease?
1) Recurrent spontaneous vertigo
2) Low frequency hearing loss
3) Tinnitus
4) Aural fullness
If vertigo symptoms are less than 24 hours, is it BPV or Vestibular Neuronitis?
If it lasts for about 3 months?
1) Vestibular Neuronitis
2) BPV
What is an autosomal recessive disorder due to a mutation on chromosome 9?
What is the onset?
1) Friedrich’s Ataxia
2) Before age 20
What symptoms are associated with Friedrich’s Ataxia?
1) Gait ataxia
2) Dysarthria
3) Impaired position/vibratory sense in legs
4) Muscle weakness
5) Absent tendon reflexes in legs
What is often the cause of death in patients with Friedrich’s Ataxia?
Cardiomyopathy
Ataxia-Telangiectasia
- What are the inheritance pattern
- What Chromosome is the issue?
- Autosomal Recessive
- Chromosome 11
Ataxia-Telangiectasia is characterized by?
1) Progressive ataxia
2) Oculocutaneous telangiectasia
3) Immunologic deficiency
Around what age does the oculocutaneous telangiectasia usually appear?
Teen years
What Igs are decreased with Ataxia-Telangiectasia?
The immunological impairment becomes evident later in childhood and is manifested by?
1) IgA and IgE
2) Recurrent sinopulmonary infections
Deficiency of B12 can cause what?
Fatigue
Gait/balance problems
Distal sensory loss
Babinski/Romberg Sign
Vit B12 Deficiency causes degeneration of?
Posterior columns
lateral corticospinal tracts (UMN)
Peripheral neuropathy (LMN)
