Vertigo

Question 1

Peripheral Causes Vertigo

Answer 1

Benign Paroxysmal Positional Vertigo
Vestibular neuritis & viral Labrynthitis
Menieres disease
Herpes Zoster Oticus (Ramsay Hunt Syndrome)
Drug toxicity (aminoglycoside, salicylate, quinine)
Otitis Media
Perilymphatic fistula 
Semicircular canal dehiscence syndrome
Labrynthine concussion
Acoustic neuroma

Question 2

Central causes Vertigo

Answer 2

Brainstem (vertebrobasilar) ischaemia / dissection
Cerebellar infarction/ hemorrhage
multiple sclerosis
migrainous vertigo
chiari malformation
episodic ataxia type 2

Question 3

Exam for Central Vertigo

HINTS: Head Impulse Test, Nystagmus, Test of Skew

Answer 3

Abnormal = INFARCT
Impulse normal
Fast phase Alternating
Refixation on Cover Test

if any 1 or 3 abnormal
Sensitivity 100%
Specificity 96%

Question 4

Management Vertigo: Symptomatic relief

Answer 4

• Prochlorperazine: 5 mg PO TDS
• Promethazine: 25 mg PO q6h
• Epley manouvre for BPPV