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Neuromus 1 > exam 2 - peri and central > Flashcards

exam 2 - peri and central Flashcards

1
Q

acute unilateral vestibular loss - sym

A
  • Sudden onset
  • May have hearing loss
  • Spontaneous nys – horizontal, alexander law
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2
Q

acute unilateral vestibular loss - test

A
  • Nys decreases with fixation
  • (+) HIT
  • (+) head shake test
  • (+) vibration induced nys
  • (+) DVA
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3
Q

Vestibular neuritis - what is it

A

a disorder that affects the vestibulocochlear nerve of your inner ear, inflammation

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4
Q

Vestibular neuritis - sym

A
  • Vertigo that can last for days
  • No hearing loss, fullness in the ear
  • May have flu like sym prior to onset of vertigo
  • Nystagmus - Spontaneous nys
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5
Q

Vestibular neuritis - test

A

none stated

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6
Q

Vestibular neuritis - medical treatment

A

Medical management: effective within the first month
- Methylprednisolone
- 10-day course of prednisone

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7
Q

Chronic unilateral vestibular loss - sym

A
  • Chronic Dizziness
  • Walking - Off balance, Blurring with head movements
  • May have hearing loss
  • Induced by head movements
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8
Q

Chronic unilateral vestibular loss - test

A
  • (maybe +) HIT
  • (+) DVA
  • May fall when standing on foam – EC
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9
Q

Subjective BPPV - def

A

Adults that have BPPV with no nys but the sensation of BPPV with dix hall pike

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10
Q

subjective BPPV intervention

A

Treat like they have a positive test – do not treat pt forever

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11
Q

Meniere’s disease - what is it

A

excessive buildup of endolymph causing a higher pressure than normal which can disrupts the sensory system

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12
Q

Meniere’s disease - sym

A
  • Ear pressure (fullness)
  • Low frequency hearing loss
  • Tinnitus
  • Spontaneous attacks – drop attacks
  • Vertigo attacks – 20 min - hours
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13
Q

Meniere’s disease - treatment

A

Endolymphatic surgery

Vestibular ablation
- Chemical
- Surgical

Medical management
Intratympanic steroids
Salt/caffeine restriction
Diuretic
Vasodilator
Immunotherapy

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14
Q

Meniere’s disease - test

A
  • Asymmetric hearing
  • Difficulty standing on foam
  • Possible autoimmune family history
  • Abnormal caloric
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15
Q

Superior canal dehiscence - what is it

A

sound or pressure induced vertigo of the superior SSC (rare)

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16
Q

Superior canal dehiscence - sym

A
  • Load sound cause object in the VF to move
  • Dizziness intros by coughing or sneezing
  • conductive hearing loss
  • Hear their heart, voice, maybe eye movement in the effected ear, foot steps hitting the ground, 262 Hz tunning fork on malleolus
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17
Q

Superior canal dehiscence - treatment

A

surgical

18
Q

Ramsey hunt syndrome - sym

A
  • Ipsilateral facial weakness
  • Ear pain

may have hearing loss

19
Q

Bilateral vestibular disease - def

A

hypofunction of the vestibular nerves or labyrinths on both sides

20
Q

Bilateral vestibular disease - sym

A
  • Oscillopsia
  • Ataxia – wide base of gait
  • Frequent falls
  • No vertigo – no spinning
21
Q

Bilateral vestibular disease - test

A
  • (+) Bilateral HIT
  • (+) DVA
  • Fall on posturography 5&6 – sometimes 4
  • Decrease caloric findings
22
Q

Bilateral vestibular disease - treatment

A

VOR – just to see if anything is left

Substitution exercises

23
Q

Psychiatric dizziness - three categories

A
  • panic disorders
  • agoraphobia
  • hyperventilation syndrome
24
Q

Psychiatric dizziness - symptoms

A
  • floating, spinning, swimming of the head
  • tension headaches
  • palpations
  • gastric disorders
  • sym constant
    o may increase with stress
25
Q

what is Persistent postural perceptual dizziness (PPPD)

A

Functional movement disorder – someone can appear to have a spinal cord injury, they cannot stand or walk, but they can actually move all of their bones and muscles

26
Q

Persistent postural perceptual dizziness (PPPD) - presentation

A
  • These pt brains are built differently – the morphology of their grey matter is different
  • There is normally a vestibular trigger – BPPV, neuritis
  • These pt do not recover from their vestibular issues – long term problem
    o Maladaptive
27
Q

MS - cause

A

demylienation of the axons

28
Q

ms - sym

A
  • Focal neuro signs
  • Recurrent attack of vertigo
  • Vertical nys – non fatiguing
    o See saw nys
29
Q

MS - age group

A

20-40

30
Q

Vestibular migraine - occcurance

A

most common vestibular issue

31
Q

Vestibular migraine - sym

A
  • Pain in the head and neck
  • Visual changes – photophobia, blurring
  • Mood changes
  • May be autosomal dominant – trait seen in families
  • Sometime positional nys – persistent
32
Q

what is a Chiari malformations

A

cere goes through the foramen magnum

33
Q

Chiari malformations

A
  • Headache
  • Neck pain
  • Down beating nys with IR goggles
  • Balance problems
  • Dysphagia
  • Weakness
  • Vertigo
34
Q

Perilymphatic fistula (rare) - sym

A
  • Vertigo induced by – coughing, sneezing, Valsalva
  • Fluctuating dizziness
  • May have hearing loss
35
Q

Perilymphatic fistula (rare) - cuases

A
  • Barotrauma
  • Head injury
  • Heavy lifting
36
Q

Perilymphatic fistula (rare) - tests

A
  • (+) tragal pressure
  • (+) Valsalva test
  • (+) occasional tullios phenomenon
37
Q

Perilymphatic fistula (rare) - treatment

A

refer out

38
Q

Orthostatic tremor - presentation

A
  • Tremor
    o Tremor that cannot be seen
    o Position specific – standing
    o Disappears or decreases – walking, sitting, supine
  • CC: I cannot stand for longer than a few minutes
  • Fear of falling
39
Q

Orthostatic tremor - medical management

A
  • Gabapentin
  • Primidone
  • Pregabalin
40
Q

Central vestibular - sym

A
  • Inability to walk – gait ataxia
  • Dizziness/vertigo
  • Head tilt to the side
41
Q

Central vestibular - tests

A
  • (-) HIT
  • Focal neuro signs
  • Changing direction of nys
  • Sig imbalance

Neuromus 1 (15 decks)

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