Neuro 16 - Clinical approach to acute vertigo

Question 1

What is oscillopsia

Answer 1

Seeing environmental motion

indicates nystagmus

Question 2

There are 2 types of illusory self-motion

Answer 2

1. Low current - feeling of gentle rocking of self

2. High current - violent spinning of self and room

Question 3

What are the main neurological diagnoses of acute vertigo?

Answer 3

1. BPPV
2. Vestibular neuritis
3. Migrainous vertigo
4. Stroke
5. Menieres (rare)

Question 4

Define vertigo

Answer 4

Illusions of movement –> usually rotational

Symptoms include: dizziness, giddiness, unsteadiness

Question 5

Balance disorders can be categorised into

Answer 5

Peripheral vestibular disorders - labyrinth and CN8 nerves. e.g. Vestibular neuritis, BPPV, Menieres disease

Central vestibular disorders - CNS

Question 6

What are the different types of vestibular disorders

Answer 6

Acute: vestibular neuritis (labyrinthitis), labyrinthine concussion

Intermittent: Benign paroxysmal positional vertigo (BPPV)

Recurrent: Menieres disease - rare, migraine - common

Progressive - Acoustic neuroma (CN8)