Common cerebral histories - Vertigo

Question 1

What would you want to ask about in relation to veritog?

Answer 1

• Is it vertigo?
• Duration
• Onset
• Progression
• Timing - intermittent/continuous
• Previous attacks
• Impact

Question 2

What are general features you would want to ask about in relation to a presentation of vertigo?

Answer 2

Fever

Question 3

What ENT questions would you want to ask someone with features of vertigo?

Answer 3

• Ear
  
  • Hearing loss
  • Tinnitus
  • Otalgia
• Nose
  
  • Rhinorrhoea
  • Epistaxis
• Throat
  
  • Sore throat
  • Odynophagia

Question 4

What neurological features would you want to ask someone with features of vertigo?

Answer 4

• Fits/faints/funny turns
• Weakness
• Numbness
• Tingling/paraesthesia
• Speech
• Hearing
• Visual disturbance
• Memory loss
• Neck stiffness
• Phtophobia

Question 5

What features in association with vertigo would suggest BPPV?

Answer 5

• Attacks of sudden rotational vertigo
• Evoked by head turning
• Lasts 30 seconds

Question 6

What features associated with vertigo may suggest vestibular neuritis?

Answer 6

• Often preceded by UTRI
• Sudden rotational vertigo and vomiting
• Lasts several days but imbalance may persist
• May recur several times per year

Question 7

What features associated with vertigo would suggest labrynthitis as a cause?

Answer 7

• Often preceded by URTI
• Severe vertigo and hearing disturbance
• May have tinnitus, otalgia, nausea, fever

Question 8

What features associated with vertigo would suggest meniere’s as the cause?

Answer 8

• Triad - tinnitus + vertigo + hearing loss
• Attacks last for minutes to hours

Question 9

What features associated with vertigo would suggest vetibulobasilar insufficiency as a cause?

Answer 9

• Momentary vertigo attacks precipitated by neck extension
• Elderly with cervical spondylosis

Question 10

What are common peripheral causes of vertigo?

Answer 10

• BPPV
• Neuritis
• Labrynthitis
• Meniere’s
• Acoustic neuroma
• Chronic otitis media
• Eustacian tube dysfunction
• Ramsay-Hunt syndrome
• Cholesteatoma

Question 11

What are common causes of central vertigo?

Answer 11

• Vertebrobasilar insufficiency
• Vertebrobasilar stroke
• Cerebellar stroke
• Neuro conditions - MS, epilepsy, brain tumour, migraine
• Head injury

Question 12

What drugs can cause vertigo?

Answer 12

• Alcohol
• Salicylates
• Quinine
• Aminoglycocides
• Metranidazole
• Co-trimoxazole
• Diuretics