Dizziness and vertigo

Question 1

Dizziness

Answer 1

Dizziness of faintness precedes syncope and represents an incomplete form in which cerebral perfusion has not fallen sufficiently to cause loss of consciousness

Aetiology:
– most common cause- vasovagal syncope (simple faint)
—- as a result of- reflex bradycardia and peripheral and splanchnic vasodilation

– fear, pain and prolonged standing are principle causes.

Fainting almost never occurs in the recumbent position

Question 2

Vertigo

Answer 2

An illusion of rotary movement where the patient feels that the surroundings are spinning.

Results from a disease of the inner ear (auditory/vestibulocochlear nerve)
– this is because:
—- semicircular canals, which indicate rotational movements, and the otoliths (utricle and saccule), which sense linear acceleration. these organs provide information to the brain stem and cerebellum via the 8th cranial nerve regarding the position and movement of the head. (so damage to 8th cranial nerve can cause vertigo)

Benign paroxysmal positional vertigo:
– accounts for about half of the cases with peripheral vestibular dysfunction

Causes:
– vestibular neuronitis- caused by a viral infection affecting the labyrinth

– Menieres disease- due to the build up of endolymphatic fluid in the inner ear

– central causes are usually vascular and may also be due to multiple sclerosis