dizzy patient Flashcards
causes of dizziness
- cardiovascular
- haematological and metabolic
- anxiety
- neuro
- drug side effects
- migraine
- otological
- trauma
what is vertigo
sensation of motion: spinning, falling, being pushed
diagnosis if vertigo lasts seconds
BPPV
diagnosis if vertigo lasts hours
Meniere’s
diagnosis if vertigo lasts days
vestibular neuritis
diagnosis if vertigo is variable
migraine associated vertigo
what are some associated symptoms with vertigo
- hearing loss
- tinnitus
- aural pressure
- migraines
- sensory sensitivity
- sound or pressure induced symptoms
light sensitive during the dizzy spell?
vestibular migraine
does one ear feel full or do you notice a change to your hearing around the time of dizzy spell?
Meniere’s disease
what is the commonest cause of vertigo on looking up
benign positional paroxysmal vertigo
causes of BPPV
- head trauma
- ear surgery
- idiopathic
pathophysiology of BPPV
otoconia from utricle displaces into semicircular canals
most commonly into posterior SCC
when do you get vertigo in BPPV
- looking up
- turning in bed
- first lying down in bed at night
- bending forward
- getting out of bed in the morning
- rising from bending
- moving head quickly
treatment of BPPV
- epley manoeuvre
- semont manoeuvre
- Brandt-Daroff exercises
what is vestibular neuronitis
Vestibular neuritis is a condition that affects the vestibular nerve, which connects the inner ear to the brain, causing prolonged vertigo usually in the absence of significant hearing loss
symptoms of vestibular neuronitis
- Severe, continuous vertigo
- Inability to balance or walk straight.
- Nausea and vomiting, which can lead to dehydration and extreme fatigue
what is labyrinthitis
- vertigo
- hearing loss
- tinnitus
pathophysiology of Meniere’s disease
endolymphatic hydrops
presentation of Menieres disease
- recurrent, spontaneous, rotational vertigo with at least two episodes >20mins
- new tinnitus on affected side
- aural fullness
- documental SNHL on at least one occasion
- low frequency sensorineural hearing loss
what does this audiograph show
menieres disease
management for menieres disease
- supportive treatment during episodes
- tinnitus therapy
- hearing aids
drugs that can help migraines
- absorptive agents e.g. triptans
- prophylaxis e.g. propanolol, amitriptyline
what does vestibular shwannoma cause
progressive imbalance and hearing loss with tinnitus
