Ears - Dizziness

Question 1

What does ‘dizziness’ encompass (5)

Answer 1

Vertigo 
Disequilibrium 
Light-headedness 
Ataxia 
Diplopia

Question 2

3 types of dizziness

Answer 2

Central
CV
Peripheral

Question 3

What is central dizziness caused by

Answer 3

Vestibular nuclei/BS upwards

Question 4

Typical PS central dizziness

Answer 4

Pt >60
Moment of disequilibrium + veering to one side
Ataxia
Gradual loss of balance

Question 5

Causes of central dizziness (4)

Answer 5

SOL
Post trauma
Degenerative - MS
Intoxication

Question 6

PS of CV dizziness (5)

Answer 6

Feeling faint/weak at the knees 
<60 y/o 
Syncope 
Light headed 
Fainting

Question 7

Causes of CV dizziness (6)

Answer 7

HTN 
Postural HoTN 
arrhythmias 
Vasovagal 
Hyperventilation 
Dx

Question 8

Peripheral dizziness is caused by

Answer 8

Labrythine or vestibular nn

Question 9

PS peripheral dizziness

Answer 9

Sudden eps of vertigo
N+V
HL
Tinnitus

Question 10

causes of peripheral dizziness (4)

Answer 10

BPPV (s)
Menieres (min/hr)
Vestibular migraine - min/hrs
Vestibular neuronitis - days

Question 11

Vertigo

Answer 11

Hallucination of movement, world spinning on your movement

Question 12

BPPV

Answer 12

Episodic vertigo when head is moved in certain directions (e.g. moving head in bed)

Question 13

BPPV timescale

Answer 13

s-mins

Question 14

Cause of BPPV

Answer 14

Otoliths getting caught in ant SC canals

Question 15

Diagnosis BPPV

Answer 15

Dix-Hallpike manouvre

Question 16

Outcome Dix-hallpike manouvre BPPV

Answer 16

Nystagmus observed, rotating towards affected ear

Question 17

Mx BPPV (3)

Answer 17

Epley maneuver (may req several goes) 
Avoid sedatives
rarely --> surgery

Question 18

When can a vestibular migraine occur?

Answer 18

Before, during or after a migraine

Question 19

How long does vestibular migraines typically last

Answer 19

15-20mins

Question 20

PS basilar migraines

Answer 20

HL + Tinnitus

Question 21

Menieres and driving

Answer 21

Can’t drive once diagnosed

Question 22

Triad of Sx Menieres disease

Answer 22

Vertigo attacks (10min-24h)
Tinnitus
Fluctuating SNHL

Question 23

Other Sx Meniere’s disease

Answer 23

Aural fullness

Question 24

Are Meniere’s attacks mainly unilateral or bilateral

Answer 24

Unilateral

Question 25

Tx Menier’es (4)

Answer 25

Vestibular sedative
L term - B histamine
Avoid caffiene/salt
reassure + psycho support

Question 26

Last resort Tx Meniere’s

Answer 26

gentamicin (ototoxicity)

Question 27

What is vestibular neuronitis

Answer 27

Inflammation of the vestibular part of CN8

Question 28

Sx vestibular neuronitis

Answer 28

Vertigo lasting several days

NO hearing loss

Question 29

Mx vestibular neuronitis

Answer 29

Prochlorperazine (acute)

Vestibular rehab + sedatives

Question 30

Sx vestibular labyrinthitis

Answer 30

Vertigo

HL/Tinnitus

Question 31

Do you describe nystagmus in the direction of the slow or fast phase>

Answer 31

fast phase

Question 32

PS of nystagmus - peripheral issues

Answer 32

Horizontal/rotation nystagmus

Question 33

PS of nystagmus - central issues

Answer 33

Vertical nystagmus

Question 34

PS of nystagmus - destruction of labyrinthe

Answer 34

Nystagmus away from damaged ear

Question 35

PS of nystagmus - irritative lesion

Answer 35

Towards affected ear

Question 36

PS of nystagmus - cerebellar lesion

Answer 36

Ipsilateral side