dizziness and vertigo Flashcards
what is dizziness
sensation of light headiness
what is vertigo
sensation of movement, usually spinning, of either self or surroundings in the absnce of such movement, with associated loss of balance
name 7 vertigo history specific questions
- when was the episode
- how long did it last
- what were you going when it happened
- can you think of anything that may have triggered it
- associated symptoms
- have you have any other episodes since
- have you experienced anything like this in the past
vertigo associated symptoms
- hearing loss, tinnitus, aural fullness
- nausea, vomiting, fatigue
- weakness, numbness, tingling
- dizziness, palpitation
- shortness of breath, chest pain
- changes in vision
what is Meniere’s disease
recurrent episodes (at least 2) of unilateral vertigo of unknown cause
Meniere’s disease presentation
- violent episodes of paroxysmal vertigo that last at least 20 minutes with prostration, nausea and vomiting, tinnitus, fluctuating hearing loss and aural fullness
- hearing loss is sensorineural
- hearing usually returns to normal but recurrent attacks can lead to gradual deterioration and low frequency loss
Meniere’s disease management
- during attack -> supportive
- reduce salt, alcohol, caffeine and stress
- B-histamine, prochlorperazine (buccastem), cyclizine, antihistamine (meclizine)
- acute attack -> buccal or IM prochlorperazine (admission sometimes required)
- prevention with beta-histine and vestibular rehabilitation exercises
- surgical -> Grommets, endolymphatic shunt
what is benign postural paroxysmal vertigo
recurrent episodes of vertigo caused by detachment of one otoconia from the utricle, which becomes lodged in the semi-circular canals
what is benign postural paroxysmal vertigo
recurrent episodes of vertigo caused by detachment of one otoconia from the utricle, which becomes lodged in the semi-circular canals
BPPV presentation
- recurrent episodes of rotational vertigo that last 30-60 seconds and are initiated by certain movements (e.g. looking up, getting out of bed, rolling over, moving head quickly in one direction
- vomiting
- no auditory symptoms
BPPV diagnosis
BPPV diagnosis
Dix Hallpike
describe Dix Hallpike
- sit patient up and turn head 45 degrees to one side
- look in patient’s eyes
- drop patient onto back and extend neck 30 degrees over couch, maintaining 45 degrees rotation
- look in patient’s eyes
- positive test -> rotational nystagmus
BPPV management
Epley manoeuvre
describe Epley manoeuvre
- from Dix Hallpike position
- rotate head 90 degrees so that the ear of unaffected side is facing the floor, maintaining neck extension
- roll patient onto unaffected side and sit them up, maintaining 45 degree rotation
- this should displace the otolith out of the semi-circular canal
