Neuro week: Ears Flashcards
Questions to ask in ear history
- hearing loss
- pain (otalgia)
- discharge
- noises (tinnitus)
- dizziness (vertigo)
External, middle, internal ear
Which is affected in conductive/sensorineural hearing loss
External and middle in conductive
Internal in sensorineural
Questions to ask in a dizziness history
- how long problems have occurred for
- attacks or constant, frequency
- movement sensation
- how long is each attack (seconds, minutes, hours)
- associated symptoms
- exacerbating and relieving factors
- response to treatments
Otological causes of vertigo
- BPPV
- vestibular neuronitis
- labyrinthitis (hearing loss + vertigo)
- Meniere’s disease
Define tinnitus
Sound heard for more than 5 minutes in absence of external stimulation.
NOT after exposure to loud noise
What causes tinnitus
Aberrant spontaneous activity from altered state of excitation or inhibition with auditory system
What to assess on examination of a dizzy patient
- Ear test
- nystagmus
- head thrust
- lower CN
- coordination
- tremor, gait
What is cyclizine
Vestibular suppressant
Treatment for vertigo
Anti-emetic
Non-otological causes of vertigo
- migraine
- stroke
- loss of consciousness
- neck pain
- getting up too quickly from bed
- palpitations
- anxiety
What happens in Meniere’s disease
Swelling of endolymphatic space in inner ear