Dizziness+vertigo Flashcards
Dizziness
instability, the feeling of about to fall or the tendency to lose balance
Vertigo
Illusion of movement of the world around you, usually rotation
Nystagmus
horizontal or vertical periodic rhythmic ocular oscillation. normal at extremes of vision
Causes of balance problems
Brainstem/cerebellar infarct
Tumours
Parkinson’s Disease
Peripheral vestibular disorders
Vestibulo-ocular reflex
Keeps eyes on target by correcting for head movement
Vestibulo-spinal reflex
Keeps you standing upright
Benign paroxysmal positional vertigo (BPPV)
sec-mins attacks of dizziness which occur in clusters –> often in elderly/bed-bound
Due to Ca carbonate/canalolithiasis debris in semicircular canal
Hallpike test, if positive then Perform Epley Maneuver (trent-particle repositioning)
Causes of Labyrinthitis
Usually viral infection (after URTI) but can be bacterial infection, head injury, extreme stress, allergy or drug reaction, changes in air pressure
Unclear pathology due to vestibular nerve inflammation
Ladyrinthitis
Occurs in single episodes of intense vertigo with horizontal nystagmus causing anxiety, nausea and vomiting. can last for days –> treat with hydration, rehabilitation & vestibular sedatives
Vestibular sedatives
Include Prochlorperazine (D2 agonist with antipsychotic side effects, EPSE/NMS) and Cinnarizine (drowsiness) Dont use too long as can delay recover and increase symptoms
Symptoms of Meniere’s Disease
Disorder of the inner ear which causes vertigo, tinnitus, fluctuating hearing loss (low freq) often with a feeling of pressure in the inner ear
May experience ‘tumakrin crisis’
Meniere’s Disease
An idiopathic inner ear disorder thought to be linked to endolymphatic hydrops(excess fluid in the inner ear)
Can prevent attacks by reducing salt, caffine, chocolate and giving diuretics
Tumarkin crisis
‘Drop attacks’ which are more common in later disease causing sudden, severe attacks of vertigo which can cause the pt to collapse
