Neurol - MedEd - dizziness Flashcards
Dizzy - types of symptoms
1) Black out, sensation of passing out, + LOC = presyncope, syncope
2) Sensation of room spinning/unsteady on feet, no LOC = vertigo - central or peripheral
Peripheral vertigo - s/s
-Need imaging?
+ tinnitus, hearing loss
no focal neurologic deficits, no brain stem findings
-no imaging needed
Central vertigo - s/s
No tinnitus, no hearing loss
+ neurologic signs, + brain stem lesions, + focal neurologic signs, + cerebellar
Central vertigo - pathophys
Posterior fossa insults
Central vertigo - imaging
MRI
Causes of posterior fossa lesions - pathophys
1) MS
2) CVA/stroke
3) Tumour
4) Abscess
5) Complex migraines
6) Seizures
- Treatment will depend on the cause
Posterior fossa lesions - signs and symptoms
Focal neurologic deficits
Cerebellar symptoms
No ear symptoms
Diagnosis of posterior fossa lesions
MRI
3 different peripheral vertigos - types
1) BPPV
2) Vestibular neuritis (no hearing loss), labyrinthitis (hearing loss)
3) Meniere’s disease
Pathophys of BPPV
Otolith
S/S of BPPV
Recurrent, reproducible, positional vertigo
Last <1min
i.e. always with movement
Diagnosis of BPPV
Dix-Hallpike/rotary nystagmus
No imaging necessary
Treatment of BPPV
Epley’s
Get stone out
Pathophys of vestibular neuritis/labyrinthitis
Post-viral
S/S of vestibular neuritis/labyrinthitis
4 weeks post URTI
1-10min of vertigo
May be associated with hearing loss (labyrinthitis)
May have N/V
