Dizziness Flashcards
what is dizziness?
a non specific term for a feeling of imbalance
what is vertigo?
a sensation of movement, usually spinning
what does vertigo lasting seconds suggest?
BPPV
what does vertigo lasting hours suggest?
meniere’s
what does vertigo lasting days suggest?
vestibular neuritis
what does vertigo lasting variable lengths suggest?
migraine associated vertigo
aka vestibular migraine
what symptoms, besides vertigo, are often associated with meniere’s disease?
hearing loss
tinnitus
aural pressure
what cause of vertigo should be considered if the patient gets dizzy rolling over in bed?
BPPV
what cause of vertigo should be considered if the first attack was severe and lasted hours with N+V?
vestibular neuritis
what cause of vertigo should be considered if the patient gets light sensitive during dizzy spells?
vestibular migraine
what cause of vertigo should be considered if one ear feels full or there is a hearing change when the vertigo comes on?
meniere’s disease
what are the five vestibular end organs?
ampullae of the semi circular canals (x3)
maculae of the utricle and saccule
what do the semi circular canals sense?
rotation
what do the utricle and saccule sense?
linear motion (horizontal and vertical)
what test can be done to test the function of the VOR?
the head impulse test
what does BPPV stand for?
benign positional paroxysmal vertigo
what is the most common cause of vertigo in adults?
BPPV
what are three possible causes of BPPV?
head trauma
ear surgery
idiopathic
what is the pathophysiology behind BPPV?
otoconia from the utricle displaced into semi-circular canals
what semi circular canal is often involved in BPPV?
most often the posterior one
what are five common triggers of vertigo in BPPV?
looking up lying down bending forward moving head quickly rolling over in bed
what is the diagnostic test for BPPV?
dix hallpike test
how is BPPV managed?
repositioning manoeuvres
name three repositioning manoeuvres that can be done for BPPV
epley
semont
brandt daroff
what is another name for vestibular neuritis?
labyrinthitis
what symptoms are associated with vestibular neuritis?
tinnitus
hearing loss
may have viral symptoms
what is the most likely cause of vestibular neuritis?
a virus
how is vestibular neuritis managed?
supportive - vestibular sedatives and anti-nausea medications
what is the cause of meniere’s disease?
unknown
what is the pathophysiology behind meniere’s disease?
endolymphatic hydrops
what is endolymphatic hydrops?
high pressure in the endolymph system of the inner ear
how is meniere’s disease diagnosed?
a diagnosis of exclusion
how is meniere’s disease managed?
supportive during episodes
treat tinnitus
hearing aids
how can episodes of meniere’s disease be prevented?
salt restriction
minimise caffeine and alcohol intake
manage stress
what is the most common auditory symptom in vestibular migraine?
phonophobia
what is the treatment for vestibular migraine based on?
lifestyle modifications
trigger factors
what pharmacological treatments can be used for vestibular migraine?
abortive agents
prophylaxis
what are the abortive agents for vestibular migraine?
triptans
what drugs can be used as prophylaxis for vestibular migraine?
propranolol
amitriptyline
what is vestibular schwannoma?
a benign tumour of the CN VIII nerve sheath
how does vestibular schwannoma present?
progressive imbalance
hearing loss
tinnitus
how is vestibular schwannoma diagnsoed?
MRI
