Dizzy Patient Flashcards
dizziness is…
a non specific term- could indicate vertigo, pre-syncope, disequilibrium
what are some words used by pt to discribe their vertigo-associated dizziness
spinning, falling, being pushed
CV dizziness is usually more…
lightheadnedness, syncope, palpittaions
blackouts, paraesthesia, speech/swallowing issues is more due to…
proprioceptive- DM, arthritis, neurology
what is vertigo
spinning sensation
T/F: males get it more than females
F: females more susceptible (3:1)
causes of vertigo
BPPV, Meniere’s, Vestibular Neuritis/ Labrinthitis, migraine associated vertigo
key hx for vertigo and its cause
BPPV: seconds, dizzy when rolling in bed/ standing up
meniere’s: hours, 1 ear feels full
Vestibular neuritis: days, 1st attack severe- nausea/vomiting
Migraine-asscoiated: comes on with migraine, light sensitivity
associated symptoms of vertigo
hearing loss, tinnitus, aural pressure, migraines, nystagmus
which cause of vertigo is the most common
BPPV
aetiology of BPPV
idiopathic, head trauma, surgery
pathophysiology of BPPV
the crystals move from the utricle to the SCC
which SCC are crystals most commonly displaced to
posterior SCC
s/s of BPPV
vertigo on looking up or moving head, turning in bed, first lying down/getting out of bed
ix of BPPV
dix hallpike test +ve
tx for BPPV
epley manœuvre, semont manœuvre, Brandt-daroff exercises
what vertebrobasilar insufficiency
a ddx for BPPV- associated to other hypoperfusion symptoms of posterior brain (visual disturbance, weakness, numbness)
vestibular neuritis is due to?
viral, ototoxicity
s/s of vestibular neuritis
vertigo lasts DAYS, tinnitus
how to differentiate between neuritis and labrynthitis
labirynthitis= hearing loss too
mx of vestibular neuritis
supportive- vestibular sedatives, anti-emetics
rule of 3: 3 days in bed, 3 weeks off work, 3 months dizzy
pathophysiology of Meniere’s
endolymphatic hydrops- high pressure in endolymph system of the inner ear
s/s of Meniere’s
recurrent, spontaneous rotational vertigo with at least 2 episodes in <20mins, new tinnitus on affected side, aural fullness, sensorineural hearing loss
audiogram for Meniere’s
2 separate lines that gradually join
mx of Meniere’s
supportive tx during episodes, hearing support- hearing aids etc, reduce pressure (salt restriction, caffeine, alcohol)
what are possible medications for meniere’s
ITS and ITG
how many migraine sufferers also have vertigo
25%
mx of migraine vertigo
lifestyle modification- avoid triggers
rx- abortive agents (triptans), prophylaxis (amitryptiline)
what is a vestibular schwannoma
benign tumour of CN VII nerve sheath
s/s of vestibular schwannoma
progressive imbalance, hearing loss + tinnitus
ix for vest. schwan
MRI
superior semi-circular cana dehiscence is…
thinning of bone over superior SCC, can hear noises in head (eyeballs moving etc)
