Ear: Vertigo [motion sickness]

Question 1

Patient presents with dizziness, as if the room is spinning, feeling of constant motion. Dx?

PE: nystagmus, hearing and eye exam, gait, cardiac exam (MRI or CT)

Answer 1

Vertigo

Constant: central, possible brain lesion

Peripheral: episodic, inner ear problem

Question 2

How do you diagnose vertigo?

Answer 2

Hx of symptoms and PE - including the Hallpike Maneuver

Question 3

Treatment for vertigo?

Answer 3

meclizine &; positional therapy (Epily maneuver to put crystals back into place)

Peripheral: vestibular rehabilitation