Vertigo Flashcards
Define vertigo
Either a sensation of motion when there is no motion or an exaggerated sense of motion in response to movement
Two types of vestibular dysfunction
Peripheral and central
Peripheral
Onset is sudden
Often associated with tinnitus and hearing loss
Horizontal nystagmus may be present
Etiologies of peripheral
BPPV
Herpes zoster
Otitis media
Aminoglycoside toxicity
Central
Gradual onset
No associated auditory sx
Can present with: ataxia, dysarthria, dysphasia, focal or lateralized weakness
Etiologies
Brain stem ischemia
Multiple sclerosis
Veistibar migraine
Vertigo should be distinguished from
Imbalance
Light headedness
Syncope
What is typical with acute vertigo?
N/V
Physical examination includes
Evaluation of ears
Observation of eye motion ( nystagmus in response to head turning)
Cranial nerve examination
Romberg testing
In what condition do you see horizontal nystagmus with rotating component in which the fast phase usually beats away from the diseased side
Acute peripheral lesions
What tends to inhibit nystagmus except in very acute peripheral lesions or CNS disease
Visual fixation
In what condition, dix-hallpike testing will elicit a delayed onset of fatigable nystagmus
Benign paroxysmal positioning vertigo
Non-fatigable nystagmus in the dix-hall pike position indicates
CNS disease
Usually causes vertigo of sudden onset
Maybe so severe that the patient is unable to walk or stand, and is frequently accompanied by N/V
Tinnitus and hearing loss may be associated
Peripheral vestibulopathy
Gradual
Becomes progressively more severe and debilitating
Nystagmus is not always present but can occur in any direction and may be dissociated in the two eyes
Central disease
