Pathologies Flashcards
Three of the most common vestibular pathologies
BPPV, Labrynthitis/Neuritis, Meniere’s Disease
Repetitive involuntary eye movements that may be torsional, horizontal, or vertical
Nystagmus
A pathology characterized by sudden vertigo provoked by certain head movements
Benign Paroxysmal Positional Vertigo (BPPV)`
BBPV occurs when
Some of the otoconia is displaced from the saccule or utricle and enters the SCC
BPPV affects hearing thresholds in what way
Hearing is WNL or unchanged from prior thresholds
BPPV that manifests in the horizontal canal can be diagnosed with the following test(s)
Dix Hallpike Maneuver, Roll Test, Bow and Lean Test, Case History
BPPV that manifests in the anterior canal can be diagnosed with the following test(s)
Straight Head Hang, Deep Head Hang
Otoconia which settles in the semicircular canals
Canalithiasis
Otoconia which adheres to the cupula
Cupulothiasis
When a BPPV patient experiences canalithiasis, their nystagmus is
Geotropic (beating towards the earth), with the problem ear down
When otoconia is loose in the posterior SCC, nystagmus is
Torsional and up-beating
When otoconia is loose in the lateral/horizontal SCC, nystagmus is
Horizontal
When otoconia is loose in the superior SCC, nystagmus is
Torsional and down-beating
Labrynthitis is caused by
An infection of the inner ear, nerves and bony labyrinth that affects both branches of CN VIII
Labyrinthitis is typified by symptoms such as
Unilateral SNHL
Varying to poor speech discrimination scores
Sudden hearing loss
Sudden onset tinnitus
Sudden onset vertigo
Neuritis is caused by
An infection of the inner ear, nerves and bony labyrinth that affects the vestibular portion of CN VIII
Neuritis is typified by symptoms such as
Hearing WNL (or unchanged from previous hearing)
Sudden onset dizziness/vertigo
Tinnitus
Aural Fullness
Describe Meniere’s Disease
Primary Idiopathic Endolymphatic Hydrops; an abnormal fluctuation of endolymphatic fluid, which causes an increase in pressure
Meniere’s Disease is typified by symptoms such as
Aural Fullness
Tinnitus
Fluctuating Hearing Loss
Episodic Vertigo
Episodes of Meniere’s Disease occur when
An increase of pressure in the endolymphatic duct
Can lead to a leak in the membrane in the membrane the separates endolymph and perilymph
When endolymph (high in __ ) and perilymph (high in __ ), a sudden change in ______ along the vestibular nerve can lead to vertigo
Potassium, Sodium, firing rate
Describe Vestibular Migraines
Diagnosed migraines accompanied by at least 5 episodes of vestibular symptoms (dizziness, imbalance, vertigo) lasting between 5 minutes and 72 hours
Vestibular Migraines are typified by symptoms such as
Hearing WNL or no change in hearing acuity
Moderate to severe head pain (throbbing or pulsing)
Dizziness
Sensitivity to light or sound
Nausea/vomiting
Describe acoustic neuromas
Benign slow growing tumor on the vestibular portion of CN VIII
Caused by an overproduction of Schwann cells (vestibular schwanomma)
Acoustic neuromas are typified by symptoms such as
Asymmetries on the audiogram
Positive contralateral acoustic relfex decay
Absent relfexes despite normal hearing
Asymmetrical WRS
Dizziness
Unilateral tinnitus
Unilateral aural fullness
Describe a semicircular canal dehissance
Hole in the bone covering the superior semicircular canal, creating a third window
Endolymph moves in relation to sound or pressure changes, triggering a vestibular response
SCD’s are typified by symptoms such as
Low frequency conductive hearing loss
Type A tymps
Dizziness
Tullio’s phenomenon
Oscillopsia
Autophony
Tullio’s phenomenon
Dizziness induced by sounds
Oscillopsia
Visual disturbance where still objects appear as if they moving back and forth/up and down
Autophony
Hearing your own voice or breathing in your ear
Describe an Enlarged Vestibular Aqueduct
Inner ear malformation resulting in SNHL
Congenital, typically caught in childhood
Sometimes triggered by head trauma
EVA is typified by symptoms such as
Hearing loss (conductive, SNHL, or mixed)
Dizziness (vertigo or imbalance)
Describe Mal de Barquement
“Sickness of deembarkment”
Imbalance caused by exposure to unfamiliar movement followed by an inability to calibrate once movement is normal
Sensation of still being on a boat after a cruise for example
