Vertigo

Question 1

most common causes of vertigo

Answer 1

• benign paroxysmal vertigo
• acute peripheral vestibulopathy (vestibular neuritis or labyrinthitis)
• meniere’s disease
• migraine
• psychogenic

Question 2

central vertigo

Answer 2

(central nervous system)
- TIA or stroke
- migrainenous veritgo
- MS
- cerebellopontine angle tumour

Question 3

how to check on history if a patient has vertigo

Answer 3

confirm the patient experiences spinning sensation not just light headedness

Question 4

dizzyness of vestibular origin will be provoked by

Answer 4

aggrevated by movement and releived by rest

Question 5

drugs causing dizzyness

Answer 5

antihypertensives
anticonvulsants
antidepressants
sedatives

Question 6

purely vertical nystagmus

Answer 6

central lesion
may change direction eg. beata to the left on left gaze and beat to the right on right gaze

Question 7

horizontal nystagmus

Answer 7

peripheral vestibular nystagmus
beats in the same direction regardless of the eye positon

Question 8

what does the vestibulo occular reflex test look for

Answer 8

confirms peripheral origin of the vertigo symptoms

Question 9

vestibulo-ocular reflex

Answer 9

get patient to fix eyesight on examiners nose
shake head after excluding neck pathology
eyes will move toward direction of vestibular lesion and quickly dart back
or healthy response will be to maintain eye contact with the examiners nose

Question 10

dix-hallpike manouvre

Answer 10

used to confirm benign paroxysmal positional vertigo
also locates the affected side and demonstrates the canalith mobility
success rate of the epley monouvre depends on the mobility of the canalith

Question 11

vestibular neuritis and labrynthitis

Answer 11

best rest and short ter symptom relief treatments
high dose steroids and then taper

Question 12

drugs for symptomatic treatment of vertigo

Answer 12

vestibular sedatives: benzodiazepines, antihiistamines
antiemetics and bed rest also helpfull

Question 13

pathophysiology benign paroxysmal positional vertigo

Answer 13

most common underying cause of vertigo
lodgement of a canalith insiite the posterior semicircular canal
made up of small crystals of calcium carbonate that have detatched from the urticle in the vestibule of the inner ear
movement of the canalith activates the vestibular haair cells to create asymmetrical vestibular input

Question 14

menieres syndrome

Answer 14

typically presents with vertigo, fluctuating low frequency hearing loss/tinnitus and aural pressure
managed with low salt diet and diuretics
vestibular sedatives and antiemetics fro acute attacks

Question 15

treatment for refrectory meniers

Answer 15

tympanic gentamycin and surgery

Question 16

history of upper respiratory tract or ear infection suggests the presence of

Answer 16

vestibular neuritis or labrynthitis

Question 17

vertigo duration of seconds

Answer 17

Question 18

vertigo duration of minutes to hours

Answer 18

Question 19

vertigo duration of hours to days

Answer 19

Question 20

vertigo duration of days to weeks

Answer 20

Question 21

examination of the ear may reveal

Answer 21

vessicles of herpes zoster may be visible on external ear
otoscopic examination may reveal signs of inflammation associated with acute vestibulopathy, scarring of eardrum from chronic suppurative otitis media, or an erosive cholesteatoma

Question 22

vestibular neuritis and labrynthitis

Answer 22

vestibulaar neuritis: inflammation of the vestibular nerve which results in severe vertigo for several days, thought to be due to HSV1 reactivation
labrynthitis has hearing loss as an additional feature
give high dose prednisolone and taper dose down over 18 days

Question 23

symptoms of meniere’s disease

Answer 23

idiopathic abnormal dilatation of endolymphatic organ producing symptoms of progressive vertigo, tinnitus, aural fullness and fluctuating low frequency hearing loss
no specific cure, treatment aimed at symptom control: low salt diet and diuretics

Question 24

migrainous vertigo

Answer 24

typical migrainous headache may be absent
lifestyle changes, migraine treatment and prophylaxis

Question 25

driving

Answer 25

acute symtpoms for meniere’s disease, acute laabrynthitis, acute vestibular neuritis, acute BPPV