ENT - Vertigo

Question 1

what is ramsay hunt syndrome?

Answer 1

HZV infection affected CNVII

Question 2

features of ramsay hunt syndrome?

Answer 2

SN deafness
vertigo
tinnitus
vesicles in canal/throat
otalgia
CNVII palsy

Question 3

how does ramsay hunt syndrome occur?

Answer 3

reactivation of latent varicella zoster in the geniculate ganglion of CNVII

Question 4

Tx for ramsay hunt syndrome?

Answer 4

pred

acyclovir

Question 5

what causes BPPV?

Answer 5

displacement of otoliths in the semicircular canals
leads to nystagmus and misperception of movement
usually allows vestibuloocular reflex to occur

Question 6

what is the vestibuloocular reflex?

Answer 6

eyes fixate on target while the head is moving

Question 7

features of BPPV?

Answer 7

brief vertigo (secs/mins)
positional
absence of other symptoms

Question 8

Ix for BPPV? results?

Answer 8

dix hallpike manouvre
(turn head 45 and lay back - observe eyes)

left ear: clockwise nystagmus
right ear: anticlockwise

Question 9

Tx for BPPV?

Answer 9

educate

epley and brandt daroff

Question 10

what causes meniere’s disease?

Answer 10

dilation of endolymphatic spaces

Question 11

features of meniere’s disease?

Answer 11

vertigo for hours
hearing loss
tinnitus
aural fullness
nystagmus (away from affected side)

Question 12

Ix for meniere’s disease?

Answer 12

audiometry

SN worse at lower Hz

Question 13

Tx for meniere’s disease?

Answer 13

low salt diet
acetazolamide

lorazepam + prochloperazine for acute attacks

betahistine long term

Question 14

other names for acute vestibular failure?

Answer 14

labyrinthitis

vestibular neuronitis

Question 15

what happens in acute vestibular failure?

Answer 15

inflammation of the inner ear (cochlea and vestibular system)

Question 16

features of acute vestibular failure?

Answer 16

after URTI
vertigo
nausea
vomiting 
hearing loss

Question 17

Tx for acute vestibular failure?

Answer 17

benzos
anti emetics
should resolve over a few days