The Dizzy Patient Flashcards
how will a patient explain vertigo?
room is spinning
they are spinning
most common form of vertigo?
benign positional paroxysmal vertigo
meniere’s disease is uncommon T or F
T
what part of the semicircular canals is classed as a vestibular end organ
their ampullae
what parts of the utricle and saccule are considered to be vestibular end organs?
maculae
what parts of the brain control movement?
cerebellum
brainstem
what brain conditions/symptoms can affect balance?
MS
SOL
stress
migraine
how is a patient with dizziness examined?
otoscopy neurological exam blood pressure balance system eg hallpike's test audiometry
common causes of dizziness?
medication
postural hypotension
specific causes of dizziness?
meniere's disease benign positional paroxysmal vertigo vestibular neuronitis labrynthitis migrainous vertigo
causes of benign positional paroxysmal vertigo?
head trauma
ear surgery
idiopathic
pathophysiology of BPPV
otolith displaced into the semicircular canals, particularly the posterior SCC
most common area for otoliths to deposit and why?
posterior semicircular canal
is the lowest so gravity causes it
what should otoliths be attached to?
otolithic membrane of the utricle and saccule
another name for otoliths?
calcium carbonate crystals
how long does true vertigo last?
30 secs-1 min
presentation of BPPV?
vertigo on looking up, turning in bed, lying down, bending forward etc
the eyes are facing what direction in fast nystagmus?
down (towards floor)
there is associated tinnitus and hearing loss in BPPV T or F
F, none of these
what test can be used to check for BPPV?
hallpike’s test
how is hallpike’s test done?
lie on couch with head hanging off the end
eyes open even if dizzy
turn head 45 degrees to one side
look for nystagmus
what exercise can patients do themselves to help with vertigo?
brandt-daroff exercise
prolonged vertigo with no associated ear symptoms?
vestibular neuronitis
aetiology of vestibular neuronitis?
viral
prolonged vertigo with associated tinnitus and hearing loss?
labyrinthitis
what does the epley manoeuvre hope to achieve?
the otoliths go back into the otolith organs
aetiology of labyrinthitis?
viral
Tx of vestibular neuronitis?
self limiting
support with vestibular sedatives and exercises
Tx of labyrinthitis?
self limiting
support with vestibular sedatives and exercises
presentation of menieres disease?
Hx of recurrent, spontaneous rotational vertigo that lasts hours
what are the other ear symptoms experienced in tinnitus other than vertigo?
aural fullness and worsening of tinnitus on affected side
Tx of menieres?
supportive grommet insertion gentamicin/steroids intratympanically tinnitus therapy hearing aids reduction of caffeine and alcohol
how do you test for menieres?
you can’t, it is a diagnosis of exclusion
how common is vertigo in migraine sufferers?
1/4 get it
