Dizziness Flashcards
vertigo definition
type of dizziness where it feels like the room is spinning/you are spinning
need to clarify bc not al dizziness is vertigo!
pathophysiology of motion sickness
when your eyes say you aren’t moving but your ears (semicircular canals, otolith organs) say you are
treatment of motion sickness
close eyes
focus on horizon
what can gentamicin injection (eg for bacterial otitis externa) cause that presents with vertigo, nausea and loss of balance
oscillopsia
most common cause of vertigo
benign positional paroxysmal vertigo (BPPV)
pathophysiology of benign positional paroxysmal vertigo (BPPV)
calcium carbonate crystals are displaced from otolith organs (saccule and utricle) to semicircular canals
what is the trigger of benign paroxysmal positional vertigo (BPPV)
position change eg gardening, reaching up, rolling over in bed
how long does benign paroxysmal positional vertigo (BPPV) last
30-60 seconds
is there any hearing loss or tinnitus in benign paroxysmal positional vertigo (BPPV)
neither
which semicircular canal is most common for benign positional paroxysmal vertigo (BPPV) to occur in
posterior
investigation for benign paroxysmal positional vertigo (BPPV)
brief explanation
dix-hallpike test
turn head to 45 degrees, lie patient back with head over couch, dont close eyes (looking for a nystagmus), look for 30 secs, ask if dizzy
treatment in GP practice for benign positional paroxysmal vertigo (BPPV)
epley manoeuvre
treatment at home for benign paroxysmal positional vertigo (BPPV) if recurrent
brandt daroff exercises
what is vestibular neuronitis
where does it come from
infection of vestibular nerve (part of vestibulocochlear nerve CN VIII)
probs has a cold before
how long does the vertigo last in vestibular neuronitis
when is it worst
<3 weeks
day 1
how bad is vestibular neuronitis on day
what are the associated symptoms
v bad
spinning violently
vomiting
nystagmus to opposite side
is there hearing loss or tinnitus in vestibular neuronitis
neither
treatment for vestibular neuronitis (2)
self limiting
buccastem for vomiting in future episodes
what is the difference between vestibular neuronitis and labyrinthitis in terms of pathology
labyrinthitis = whole labyrinth infected
vestibular neuronitis = vestibular nerve infected
what is the difference in presentation between vestibular neuronitis and labyrinthitis
labyrinthitis presents with tinnitus and/or hearing loss, vestibular neuronitis presents with neither hearing loss or tinnitus
shared symptoms - vertigo <3 weeks worst on day 1, vomiting, v severe spinning, nystagmus in opposite eye
is menieres disease common
no
triggers of menieres disease
alcohol
caffeine
stress
dilation of endolympathic spaces in membranous labyrinth = mixing of perilymph and endolymph = vertigo (which type)
menieres disease
how long does the vertigo last in menieres disease
> 20 mins (hours)
