Dizziness Flashcards
Define vertigo
A sensation of movement, usually spinning
For each of the following symptoms that may accompany dizziness state if they suggest a cardiac, neurlogical or vestibular cause:
- Syncope
- Visual disturbance
- Blackouts
- Lightheadness
- Palpitations
- Parasthesia/weakness
- Vertigo
- Speech + swallow problems
Cardiac
- syncope
- lightheadness
- palpitations
Neurological
- visual disturbances
- blackouts
- parasthesia/weakness
- speech + swallow problems
Vestibular
- vertigo
Match each of the following quick fire questions to their condition:
- do you get dizzy rolling over in bed?
- was your first attack severe, lasting hours with N+V?
- do you get light-sensitive during dizzy spells?
- does one ear feel full or do you notice a change to your hearing (or tinnitus) around the time of the dizzy spell?
- do you get dizzy rolling over in bed? = BPPV
- was your first attack severe, lasting hours with N+V? = vestibular neuritis
- do you get light-sensitive during dizzy spells? = vestibular migraine
- does one ear feel full or do you notice a change to your hearing (or tinnitus) around the time of the dizzy spell? = meniere’s disease
Duration of dizzy episodes is key to being able to diagnose the cause.
What type is associated with each of the following episodes:
- seconds
- hours
- days
- variable
Seconds - BPPV
Hours - Meniere’s
Days - Vestiubular neuritis/labrynthitis
Variable - migraine associated vertigo
What is the way to tell the difference between vestibular neuritis and labrythitis?
Associated tinnitus/hearing loss in labyrinthitis - not in vestibular neuritis
What is vestibular neuritis?
What is labyrinthitis?
Inflammation of the vestibular nerve
Inflammation of the labyrinth
What is the Epley Manoeurve used to treat?
Benign Positional Paroxysmal Vertigo
What is the commonest cause of vertigo on looking up?
What is the pathophysiology behind it?
BPPV
Otoconia (little crystals) from utricle are displaced into SCC
What is the diagnostic test for BPPV?
Dix Hallpike test
What kind of hearing loss results from Meniere’s Disease?
Low frequency sensorineural hearing loss
How is Meniere’s disease managed?
Supportive treatment during episodes
Hearing aids
Tinnitus therapy
Restrict:
- caffiene
- stress
- salt
- alcohol
What is the first line management of vestibular migraines?
What is the drug management options?
Trigger avoidance
- Triptans - symptomatic relief
- Prophylaxis - propranolol + more
