Etiology/Mneumonics/Dx

Question 1

Vertigo

Answer 1

Secs- BPPV, orthostasis, perilymphatic fistula, VBI, migraine
Min - migraine, TIA
Hrs - migraine, Meniere’s, neurosyphilis
Days - labyrinthitis, vestibular neuronitis, migraine
Months - acoustic neuroma, ototoxicity, MS, neurodegen

Question 2

Vertigo peripheral

Answer 2

Peripheral etiologies: sudden onset, assoc tinnitus (unilateral) or hearing loss; N/V; horizontal nystagmus

Vestibular neuritis
Labyrinthitis

Meniere’s disease
BPPV, Barotrauma

Perilymphatic fistulas

Semicircular canal dehiscence

Ethanol intoxication

Question 3

Vertigo Central

Answer 3

Central/mixed etiologies: gradual onset, no hearing loss; +/- bilat tinnitus; vertical nystagmus

Seizure, MS
Wernicke encephalopathy

Chiari malformation

Cerebellar ataxia syndromes

Migraine

Ischemia, infarct, hem, inf, or mass of brainstem
or cerebellum

Question 4

Vertigo match s/s to cause

Answer 4

Unilateral tinnitus or hearing loss - peripheral etiology
Bilateral tinnitus- central etiology
Aural fullness (sensation of something in ear) - Meniere’s
Double vision, ataxia, and/or numbness - brainstem or cerebellar lesion (serious)

Question 5

BPPV

Answer 5

Dix-Hallpike Maneuver - elicits vertigo and nystagmus

Mvmt of otoliths

Posterior Canal BPPV → upward, rotary nystagmus

Anterior Canal BPPV - downward, rotary nystagmus

Horizontal canal BPPV - nystagmus bearing towards floor (elicited by turning side to side while laying down)