Vertigo

Question 1

What is Vertigo?

Answer 1

Sensation of movement and rotation of oneself or the surrounding environment

• Typically a sensation of spinning

Question 2

What is Benign Paroxysmal Positional Vertigo (BPPV)

Answer 2

Condition that causes repeated episodes of vertigo that occur due to changes in head position

• Condition caused by the loosening of otoconia that travels in the semicircular canal
• Produces nystagmus

Question 3

How long does BPPV last?

Answer 3

Typically lasts only a few seconds

Question 4

What semicircular canal is most often involved in BPPV?

Answer 4

Posterior Semicircular Canal

Question 5

What test can be used to diagnose BPPV?

Answer 5

Dix-Hallpike Test

Question 6

What is the Dix-Hallpike Test?

Answer 6

Test that stimulates the posterior semicircular canal.

If patient experiences nystagmus and vertigo the test is performed to determine if a patient presents with BPPV or a central type lesion?

Question 7

What are characteristics of Peripheral Vertigo?

Answer 7

• Episodic and Short Duration of Symptoms
• Autonomic Symptoms Present
• Precipitating Factors
• Pallor, Sweating
• Nausea and Vomiting
• Auditory Fullness
• Tinnitus

Question 8

What are characteristics of Central Vertigo?

Answer 8

• Autonomic Symptoms less severe
• Loss of Consciousness can occur
• Neurological Symptoms

Question 9

What Neurological Symptoms Can Occur with Central Vertigo?

Answer 9

• Diplopia
• Hemianopsia
• Weakness
• Numbness
• Ataxia
• Dysarthria

(Think things associated with cerebellar damage)

Question 10

Dix-Hallpike Testing Procedure

Answer 10

i. Patient starts in sitting with the legs extended on the table and the head rotated 45 degrees to one side

ii. Patient is rapidly moved to supine with the head (still in 45 degree rotation) extended 30 degrees beyond horizontal off the end of the table

iii. Therapist holds the patient in this position for 20-30 seconds looking for nystagmus.