Vertigo

Question 1

What is vertigo?

Answer 1

the illusion of movement

Question 2

What parts of the body help maintain balance?

Answer 2

eyes
brain
inner ear
joints/muscles (proprioception)

Question 3

How is nystagmus direction described?

Answer 3

follows the quick phase - whichever way the quick phase beats is the direction

Question 4

Dizzy patient history specific questions

Answer 4

onset (first episode)
precipitating factors (eg. neck movements)
associated symptoms (eg. deafness, tinnitus)
frequency
duration
PMH

Question 5

What causes rotational vertigo?

Answer 5

acute vestibular disorder

Question 6

What causes positional vertigo?

Answer 6

BPPV
migraine

Question 7

What causes unsteadiness?

Answer 7

bilateral vestibular dysfunction
neurological disorder (eg. polyneuropathy, cerebellar disorder)

Question 8

What causes non-specific dizziness?

Answer 8

orthostatic hypertension
drug toxicity
psychogenic

Question 9

What triggers BPPV?

Answer 9

changes of head position

Question 10

What is caloric testing?

Answer 10

assesses movement in ear at different temperatures

looks for nystagmus: (COWS) = physiological
- Cold Opposite
- Warm Same

Question 11

Ototoxic drugs

Answer 11

loop diuretics
gentamicin (aminoglycoside)

Question 12

What is another name for vestibular neuritis?

Answer 12

labyrinthitis

Question 13

How long does the vertigo last in BPPV?

Answer 13

seconds

Question 14

How long does vertigo last in Menieres?

Answer 14

hours

Question 15

Associated symptoms of Menieres?

Answer 15

fluctuating hearing loss
tinnitus

Question 16

How long does vertigo last in vestibular neuritis?

Answer 16

lasting days
normal hearing

Question 17

What does the Epley manoeuvre do?

Answer 17

canalolith repositioning

Question 18

Non-surgical treatment of Menieres

Answer 18

dietary modifications
diuretics
vestibular suppressants
vasodilators
aminoglycoside therapy
intratympanic steroids

Question 19

Surgical management of Menieres

Answer 19

endolymphatic sac surgery
selective vestibular nerve section
labyrinthectomy

Question 20

General medical causes of vertigo

Answer 20

anaemia
hyperviscosity
postural hypotension
carotid sinus syndrome
dysrhythmia
mechanical dysfunction
hypoglycaemia
hyperventilation

Question 21

Neurological causes of vertigo

Answer 21

epilepsy
migraine
syncope
psychogenic
MS
ischaemia
infective disorders
tumours
foramen magnum abnormalities

Question 22

Otological causes of vertigo

Answer 22

Menieres disease
post-traumatic syndrome
positional nystagmus
vestibular neuronitis
infection
otosclerosis
Pagets disease
vascular accidents
tumours
autoimmune disorders
drug intoxication