Ear Disorders

Question 1

What is BPPV and what is it caused by?

BPPV = Benign paroxysmal positional vertigo

Answer 1

Cdtn characterised by sudden, episodic attacks of vertigo induced by changes in head position - detachment of otoliths in inner ear which results in hair cell stimulation and vertigo sx.

Question 2

Sx of BPPV?

Answer 2

• Vertigo attacks provoked by sudden head movements
• Episodes of rotational vertigo lasting between 30 sec to 1 min
• No auditory sx
• Recurrent episodes - resolves naturally over wks to mths

Question 3

What manoeuvre is the primary diagnostic test for BPPV?

Answer 3

Dix-Hallpike manoeuvre

Question 4

Mx of BPPV?

Answer 4

Epley manoeuvre - moves detached otoliths (inner ear) back to origin

Question 5

What is Meniere’s disease?

Answer 5

Inner ear disorder caused by increased fluid pressure in the endolymphatic spaces of the membranous labyrinth.

Predominantly affects only 1 ear.

Question 6

Sx of Meniere’s disease?

Answer 6

• Sudden attacks of paroxysmal vertigo
• Associated deafness
• Tinnitus
• Attacks occur in clusters - periods of remission
• Cdtn can be incredibly disabling, leaving patients bed-bound and suffering from N+V and fluctuating hearing.

Question 7

Mx of Meniere’s disease?

Answer 7

Prophylactic - betahistine (dec. freq of attacks)
Acute - prochlorperazine

Diuretics - to reduce endolymphatic fluid