Vertigo

Question 1

Vertigo of peripheral etiology involves what structure/s?

Answer 1

The vestibular system (BPV)

Question 2

What are the features of peripheral vertigo?

Answer 2

Visual fixation stops nystagmus within 1-2 minutes

Walking is preserved

Hearing may be impaired

Otherwise normal neuro exam

Question 3

Vertigo of central etiology involves which structure/s?

Answer 3

Brainstem or cerebellum (stroke)

Question 4

What are the features of central vertigo?

Answer 4

Visual fixation DOES NOT stop nystagmus

Frequent falls while walking

Hearing usually intact

Abnormal neuro exam

Question 5

What diagnosis/es should be considered for a single episode of vertigo lasting less than one minute?

Answer 5

BPV

Question 6

What diagnosis/es should be considered for a single episode of vertigo lasting from minutes to hours?

Answer 6

Migraine

TIA (of labyrinth of brain stem)

Question 7

What diagnosis/es should be considered for recurrent episodes of vertigo lasting from minutes to hours?

Answer 7

Ménière’s disease

Vestibulopathy

Question 8

What diagnosis/es should be considered for recurrent and prolonged episodes of severe vertigo lasting for days?

Answer 8

Vestibular neuritis

Multiple sclerosis

Brain stem infarct

Question 9

What is the treatment for vertigo?

Answer 9

Medications:
- antihistamines
- meclizine
- dimenhydrinate
- diphenhydramine

Referral to neurology, except BPV