Ear: Vestibular migraine, cholesteatoma, BPPV Flashcards
Define vestibular migraine?
A type of migraine that mainly presents with dizziness symptoms.
Diagnosis of exclusion.
Presentation of vestibular migraine?
≥5 vertigo attacks
hx of migraine with or without aura.
moderate-severe vestibular symptoms lasting between 5mins-72hrs.
≥50% of episodes associated with at least one migrainous feature.
Not attributed to another disorder.
Management of vestibular migraine?
Acute symptom relief:
- analgesia
- anti-emetics
- vestibular sedatives
Migraine prophylaxis
Vestibular rehabilitation
Define/cause of cholesteatoma?
Accumulation of squamous epithelium and keratin debris within the middle ear cleft and mastoid air cells.
Presentation of cholesteatoma?
Foul smelling otorrhoea
Conductive hearing loss
Squamous debris
Headaches
Otalgia
White area is often visible in the attic behind the membrane.
Diagnosis/IVx of cholesteatoma?
Otoscope
CT/MRI -assess extent of the disease.
Management of cholesteatoma?
Surgical removal of abnormal skin and squamous epithelium accumulation.
Refer to ENT
Define/cause of BPPV (benign positional paroxysmal vertigo)?
Sudden, episodic attacks of vertigo induced by changes in head position.
Due to detachment of otoliths in the inner ear.
Presentation of BPPV (benign positional paroxysmal vertigo)?
Sudden episodic
Occurs on head movement
Episodes of rotational vertigo lasting between 30secs to 1min.
n+v
NO EAR SYMPTOMS
may have hx of trauma
Diagnosis/IVx of BPPV (benign positional paroxysmal vertigo)?
ENT exam
Pure tone audiometry
Dix-Hallpike manoeuvre
Management of BPPV (benign positional paroxysmal vertigo)?
Eply manoeurve
- therapeutic manoeurve aims to detach otoliths out of the semicircular canal and back to utricle where they originate.
