Module 3 - Dizziness

Question 1

Benign Paroxysmal Positional Vertigo (BPPV) Symptoms

Answer 1

Symptoms: Spinning, Rolling, Tilting
- Lasts less than 1 min (usually 20-30 sec)
- May include nausea and diaphoresis after
NO HEARING ABNORMALITIES
- Often Positional !!

Question 2

BPPV Diagnostics and Treatment

Answer 2

• Dix-Hallpike Maneuver (might cause vomiting)
• Epley Maneuver (what to do after this maneuver?)
• Do not do HINTS testing for BPPV

Question 3

Vestibular Neuritis / Labyrinthitis *

Answer 3

Neuritis: Hearing is INTACT
Labyrinthitis: Hearing is AFFECTED (infection)

VN: acute UNILATERAL dysfunction characterized by brief severe VERTIGO, n/v, disequilibrium last a few days followed by vertigo + disequilibrium with rapid head involvement that may last for weeks to months

Question 4

VN Signs and Symptoms *

Answer 4

• Develops over period of hours
• Vertigo, N/V, disequilibrium aggravated by head movement
• Possible tinnitus but hearing remains INTACT
• Symptoms subside 48-72 hours
  > Can last 4-5 days
  > 50% for many months

Question 5

VN Causes *

Answer 5

• Viral: HSV 1+2, zoster, influenza, MMR, polio, hepatitis, EBV
• Bacterial
  > Much less common
  > inflames cochlea
  > Usually chronic OM

Question 6

VN Treatment

Answer 6

• Zines
• anticholinergics antihistamines are 1st line
• benzos are 2nd line
• sometimes can use antivirals or steroids

Question 7

Meniere’s Disease *

Answer 7

Chronic condition of the inner ear: Recurrent vertigo and FLUCTUATING HEARING LOSS
- Vertigo
- Low Frequency SENSORINEURAL HEARING LOSS
- Tinnitus
- Feeling of Fullness in ear

Cause
- Viral infections
- Immune system mediated

Question 8

Meniere’s Disease S/S *

Answer 8

• Hearing unilaterally decreased
• Sensation of fullness, pressure and tinnitus in ONE ear
• Severe vertigo which peaks within minutes then slowly subsides over hours
• Pallor, Diaphoresis, Nausea
• Spontaneous Nystagmus
• Persistent sense of disequilibrium for days is typical after an episode