Dizziness Flashcards
all dizziness is vertgo true/false
False- not all dizziness is vertigo
what is the problem with patients describing themselves as ‘dizzy’?
non- specific- ask more: did they faint?had they fallen
what is vertigo?
sensation that they/the room is spinning
what makes up the balance system? (5)
vestibular
eyesight
joint receptors
cardiac→ standign BP
brain→ stress/migraine
what can affect your eyes causign dizziness?
cataracts
what can affect your joint receptors casuign dizziness?
osteoarthritis
diabetes
what can be doen in exmination of a dizzy patient?
otoscopy
balance test
audiometry
lying/standing BP
what is BPPV?
Benign Paroxysmal Positional Vertigo
define BPPV
dizziness when moving head position i.e rolling over in bed, bendign down (gardening), leaning back (reaching to cupboard)
what is thought to be the cause of BPPV?
otilith material displaced from utricle into semicircular canals
what test is used to diagnose BPPV?
Hallpikes test
describe Hallpikes
patient lies back on couch
head at 45o
keep eyes open
what is the clincial sign seen in Hallpikes?
nystagmus
what are the two manouvres used to treat BPPV?
Epley manouvre
Brandt- Daroff exercise
what condition involces prolonged vertigo with symptoms of nausea and vomiting lasting for >3days?
vestibular neuritis
tinnitus and hearing loss is associated with vestibular neuritis true/false
false- there is no assoc tinnitus or hearing loss with vestibular neuritis
what codition is similar to vestibular neuritis but it does have assoc tinnitus and hearing loss?
labyrinthitis
how does labyrinthitis present?
sudden onset that graudually gets better
what is the treatment for vestibular neuritis and labyrinthitis?
supportive with vestibular sedatives
generally self limiting
what can be given for pateitns with vestibular neuritis/labyrinthitis that are vomiting?
buccal meds (buccostem)
cyclozine
what is menieres disease?
progressive deafness with tinnitus and vertigo
what is th ecriteria to diagnose menieres?
room spinning + vomiting
usually tinnitus + LOH before episode
lasts around 30mins
[all have to vhange at same time]
how does menieres affect you over time (years)?
destroys hearing and balance
what investigation should always be carried out in suspicion of menieres?
MRI for intrancranial lesion of schwannoma
what is the management of menieres?
buccostem during attack (vomiting)
hearing aids/therapy (tinnitus)
what is thoughtto be the mechanism behind menieres?
thought that membrane between peri and endolymph is broken every attack and the two fluids mix
n.b- due to diff in salt conc of two fluids thought that salt restricted diet could be benificial
what is a meniette?
device used in menieres that gives pulsed pressure into the ear canal- grommet insertion allows it to flow through
how can gentamicin injection be useful in menieres?
giving gentamicin injection will result in you losing sense of balance- if you have no balance you cannot suffer from an attack
