dizziness Flashcards
CRITERIA FOR HINTS
- prolonged vertigo
- nystagmus
has to have these at the time of presentation
most common cause of vertigo
BPPV
Diagnois of BPV
DIX HALLPIKE
Management of BPV
EPLEY m
cause of bpv
otoliths which become loose and stimulate the cilia in the canals
RF FOR BPV
elderly
>50
women
trigger for bpv
moving the head,
def of labrynthitis
inner ear infection
symptoms of labyrinthitis
hearing loss
vertigo/balance
naseaus
tinnitus
nystagmus
causes of labrynthitis
viral infection - cold, flu
bacterial infection - less common
what med do we give for people who have vertigo
prochlorperazine - antisickness
labyrinthitis is it usallay symmetrical or asymmetrical
usually 1 ear
labrynthitis vs vestibular neuritis
labrynthiis - affects hearing whereas VN does not
both sudden onset
both cause vertigo
both can be triggered by infection
what is meniers
inner ear disorder that cause vertigo caused by increase in pressure of lymph
symptoms of Meniere’s
vertigo -12-24 h lasting
hearing loss
tinnitus
tx of meniers
controller - betahistine
reliver- - prochlorperazine
somone comes in with dizziness what is your dx
Meniere’s
labyrinthitis
BPPV
what is vasovagal syncope
when you faint because of hyoperfusion to the brain usually by a trigger , needles, strong emotion OR STANDING FOR LONG PERIODS OF TIME
what usually precedes vasovagal syncope
a prodrome- like feeling dizzy, pale, ringing in ears, hearing loss, starnge sounds, palpitations
PATHOPHYS OF ORTHOSTATIC HYPOTENSION
when you suddenly change postion the veins delay a little to constrict so blood pools in the legs delaying venous return to the heart and thus brain
when someone presents with syncope what do w ehave to rule out
arrythmias or heart abnormalities
seizure - mimic syncope
stroke - imic syncope
first aid response to syncope
elevate the legs to increase venous return
central causes of vertigo
vascular- posterior circulation/cerebllar stroke, lateral medullary syndrome
non vascular - ms
peripheral cause of vertigo
inner ear
labrythinits
vestibular neuritis (CN 8 )
what direction is the nystagmus in peripheral vertigo
unidirectional
what direction is the nystagmus in central l vertigo
bidrectional
normal head impluse indicates
central vertigo
abnorma head impluse means
peripheral
HINTS EXAM IS FOR WHAT
ESTABLISHING WHETHER VETIGO IS PERIPHERAL OR CENTRAL?
causes ofpostural hypotension
- exclude heart problems
2.ENDO hypothyroidism, diabetes (uncontrolled) , addiosns nb!! - parkinsons
- simple dehydation 0 not enough fluids in body to control bp
- on bp tablets
any drugs we can use to treat postural hypotension?
fludriocrotisone ( also used to treat addisons )
NICE HEAD INURY
- LOC
2 VOMITTING >1 EPISODE - MEMORY LOSS
- SEIZURE
- BLOOD THINNERS?
- GCS HAS DROPPED 2 HOURS AFTER FROM 15
- SIGNS OF BASAL SKULL FRACTURE
- GCS IS LESS THAN 13 AT ANY POINT
8.focal signs
history of a patient coming in with dizziness
- how often does it happen
- anything triggering
- worse in the morning - vertigo
- is it worse when you move ur head- vertigo
- any hearing loss or eye changes /vision/nystagmus/ringing in ears
6
7
8
9
10
whats the first thing you need to estalish when a patient comes in with dizzines
is it vertigo or actual dizziness
brain causes for dizziness
in terms of dizziness what systems are you narrowing it down too
cardio
neeuro
