Vertigo

Question 1

How to distinguish vestibular neuronitis from posterior circulation stroke?

Answer 1

HiNTS exam

Question 2

Differential for peripheral causes of vertigo?

Answer 2

vestibular neuronitis

Question 3

Differentials for central causes of vertigo?

Answer 3

posterior circulation strokes, trauma, multiple sclerosis, or brain tumours

Question 4

Difference between vertigo in BPPV and vestibular neuronitis?

Answer 4

Benign paroxysmal positional vertigo usually presents as intermittent episodes of vertigo lasting for a couple of seconds precipitated by the sudden change in head movement. In this scenario, the vertigo is not episodic, and there is no mention of a trigger (such as turning the head in bed during sleep).

Question 5

Difference between vestibular neuronitis and viral labrynthitis?

Answer 5

Vestibular neuronitis is caused due to inflammation of the vestibular nerve. As a result, it will present with symptoms such as vertigo, but not hearing loss as the cochlear nerve is not affected. Other symptoms may include nausea, vomiting and balance problems. Additionally, a finding of horizontal nystagmus makes the diagnosis of a central cause of vertigo (i.e. stroke) less likely.

The presentation of viral labyrinthitis is similar to that of vestibular neuronitis; however, hearing loss and tinnitus are more likely to be present in viral labyrinthitis. In vestibular neuronitis only the vestibular nerve is involved; thus hearing is spared.

Question 6

Which type of nystagmus arises in posterior stroke vs vestibular neuronitis?

Answer 6

vertical nystagmus= post stroke
horizontal= vestibular neuronitis