Dizziness and Syncope Flashcards
What is vertigo and what can cause it?
Sense of motion, spinning, or the body being pushed or pulled
- Acute labrynthitis (N/V, inability to stand or walk)
- Chronic vertigo may accompany hearing loss and tinnitus from degeneration or noise damage of CN 8 or the inner ear
- BPV - provoked by positional changes, such as standing, sitting, or turning
- Meniere’s disease - recurrent, subacute attacks of vertigo, deafness, and tinnitus
- Vertebrobasilar TIA - isolated, episodic vertigo that is independent of head movements, accompanied by diplopia, blindness, dysarthria, ataxia
What is dizziness and what can cause it?
Lightheadedness
- Presyncope - dimming of vision, sweating or tachycardia, sense of impending fall or faint
- Orthostatic hypotension -provoked by standing
In a patient who is dizzy and loses consciousness, the prodromal dizziness favors ___ over ___.
Syncope; seizure
In syncope, patients often recall their presyncopal symptoms, are not confused, and quickly return to baseline vs. in seizure, there is a post-ictal phase during which the patient is lethargic, confused, often irritable, and unable to recall what happened
What are some causes of syncope related to specific patient activity?
Vasovagal syncope (painful, frightening, emotional experiences)
Carotid sinus syncope (wearing a tight collar)
Micturition syncope
When syncope occurs independently of patient activity, what should be considered?
Cardiac arrhythmias or heart block, particularly in patients with cardiac disease or risk factors
What defines orthostatic hypotension?
Persistent systolic pressure drop of 20 mmg Hg or more after standing for 3 minutes
If a compensatory increase in pulse is present in orthostatic hypotension, what is implicated? If not, what is implicated?
Intravascular hypovolemia; neurological problem with the autonomic system
How is positional vertigo tested?
Dix-Hallpike Maneuver -> rotatory nystagmus is present in positional vertigo
