trigger words (vertigo and tinnitus) Flashcards
CNS lesion or vestibular disease
causes of disequilibrium
often 1st sign of MS
disequilibrium
aural fullness
menieres
abnormal of this type of eye movement suggests cerebellar pathologies
pursuit or saccade eye movements
snapping a patient’s head from 45 degree angles back to face while they watch your nose
head impulse test
if there is no nystagmus this test is positive
the caloric test
indicates vestibular, nerve or brain damage
what should you do if you suspect central etiologies or an acoustic neuroma w vertigo
an MRI
performed w caloric or chair tilt/movement testing
ENG/VNG tests
this test specifically tests otolith function
VEMP
measures muscle reaction in response to sound stimulus
VEMP
saccule sound response triggers what response
ipsilateral SCM contraction
utricle sound response triggers what response
EOM potential during head vibraiton
otolith in the possterior semicircular canal
BPPV
women past menopause
frequent OM
age>50
whiplash/trauma
risk factors for BPPV
vertigo spells lasting less than 1 minute
BPPV
could also be perilymphatic fistulas and semicircular canal dehiscence (this lasts only seconds)
short vertigo resulting from turning over in bed
BPPV
BPPV subtype w vertical nystagmus
horizontal/lateral canal
upward torsional nystagmus
BPPV in posterior canal
downward, torsional nystagmus
superior/anterior canal BPPV
epley manuever
BPPV Otolith REPOSITIONING
semont maneuver
BPPV DECONDITIONING
Brandt-Daroff maneuver
BPPV deconditioning
treatment used for posterior canal nystagmus on dix-hallpike
epley maneuver (otolith repositioning)
deconditioning by turning your head and laying down repeatedly till vertigo goes away
Brandt-Daroff maneuver
involving vestibular division of CN8
vestibular neuronitis
involving vestibular and cochlear division of CN8
vestibular labyrinthitis
due to viral or post-inflammation
vestibular inflammation
asymmetrical labyrinthine inputs
vestibular neuronitis/labyrinthitis
stimulates continuous head rotation.
gait instability TOWARDS the affected side
vestibular inflammation
horizontal nystagmus AWAY from affected side
vestibular inflammation
what test is used to rule out central etiologies
head impulse test
in very suspicious cases you can use MRI
corticosteroids w/i 3 days onset and acyclovir/valacyclovir or ABX
treatment for underlying causes of vestibular inflammation