Vertigo Flashcards
A patient with Meniere’s disease has been disabled for > 1 year and is on disability. What functional level is he/she
6
What % of patients with Meniere’s disease do not respond adequately to salt restriction and diuretics
1 O%.
What is the treatment for otosyphilis
2.4 million U of benzathine penicillin IM q week for at least 3 weeks (up to I year) or I 0 million U of penicillin G IV qd for 10 days followed by 2.4 million U of I M benzathine penicillin q week for 2 weeks plus prednisone 40 - 60 mg qd for 2 - 4 weeks followed by a taper.
What % of patients with classic migraine experience vertigo
30 - 40%.
What is the rate of recurrence
30 - 50% eventually have a recurrence; 10 - 20% within I - 2 weeks of the maneuver.
What happens to the SP in the presence of hydrops
36% of patients will have a normal SP~ 32% will have a moderately enhanced negative SP; 27% will have a very enhanced negative SP; 5% will have no SP or action potential.
What % of patients with hearing loss secondary to otosyphilis improve with penicillin and steroid therapy
3I %.
A patient with Meniere’s disease is able to work, drive, and travel but must exert a great deal of effort to do so and is “barely making it.” What functional level is he/she
4 (out of 6).
After aminoglycoside treatments, when is the usual onset of dysequilibrium
4 days after treatment.
What is the success rate of the Epley maneuver after only 1 manipulation
50 -77%.
What % of patients will have improved tinnitus and hearing after endolymphatic sac surgery
50°/o experience improvement in tinnitus and 30 - 40% experience improvement in hearing.
What % of patients with vertigo secondary to otosyphilis improve with penicillin and steroid therapy
58 - 86%.
What % of patients have improvement of vertigo after endolymphatic sac surgery
70°/o experience complete relief, 20% experience decreased vertigo.
What is the success rate of singular neurectomy
79-94%.
What is the success rate after 2 manipulations
95 - 97%.
What are the most common manifestations of VBI
Abrupt, transient attacks of vertigo associated with bilaterally reduced caloric responses.
What is the treatment for this syndrome
Acetazolamide.
What 3 variables does it measure
Action potential (AP), summating potential (SP), and cochlear microphonic (CM).
What % of patients have bilateral Meniere’s disease
After 2 years, 15% of patients; after I 0 years, 25 - 35%; and after 20 years, 40 - 60°/o.
Which aminoglycosides are primarily cochleotoxic
Amikacin, dihydrostreptomycin, kanamycin, and streptomycin at high doses.
What disorders are associated with down-beating nystagmus
Amold-Chiari, cerebellar degeneration, multiple sclerosis, brainstem infarction, lithium intoxication, magnesium and thiamine deficiency.
Where is the endolymphatic sac
Anterior to Trautmann’s triangle within the dura, medial and inferior to the posterior semicircular canal.
Which way is the sigmoid sinus retracted in the retrosigmoid approach to vestibular nerve section
Anteriorly.
What is the treatment for vertigo secondary to VBI
Aspirin or ticlid if aspirin-sensitive.