Dizziness Flashcards
what are the 4 main balance systems
visual, CV, proprioceptive, vestibulo-ocular
what is vertigo
sensation of movement
what symptoms do you need to ask about in a dizziness history
duration, hearing loss, tinnitus, aural pressure, migraines or visual symptoms
what is the pathophysiology of benign positional paroxysmal vertigo (BPPV)
otoconia crystals from utricles get displaced into semicircular canals and cause vertigo on movement eg when rolling over/ standing up
what can cause BPPV
head trauma, ear surgery, idiopathic
what are symptoms of BPPV
lasts a few MINUTES: roll over/ lie down dizziness, standing up and bending down, moving head too fast
how is BPPV distinguished from vertebrobasilar insufficiency (VBI)
VBI has visual disturbances from impaired circulation to posterior brain
what is the diagnostic test for VBI
dix hallpike - sit up and lie down quickly with head resting of the bed
how do you treat BPPV
epley manoeuvre (very effective), semot manoeuvre, brandt-daroff exercises
what is vestibular neuronitis/ labyrinthitis
inflammation of vestibular nerve - usually viral
what are symptoms of vestibular neuronitis
prolonged vertigo (DAYS), rule of 3 (3 days in bed, 3 weeks off work, 3 months off balance)
what symptom distinguishes vestibular neuronitis from labyrinthitis
labyrinthitis has HEARING LOSS AND TINNITUS
how do you manage neuronitis/ labyrinthitis
anything atypical –> MRI, supportive: fluids, antiemetics, antiistamines, benzodiazepines. self limiting
what is the pathophysiology behind meniere’s disease
endolymph tubes very swollen under high pressure and burst leading to endolymph and perilymph mixing
what are symptoms of Meniere’s disease
recurrent spontaneous vertigo lasting >20 HOURS, hearing loss/ tinnitus before or after attack, feeling of aural fullness, vomiting
