Vertigo

Question 1

characteristics of vertigo

Answer 1

• illusion of movement (usually rotation) of patient or surroundings- worse on movement - being pushed from side to side

Question 2

symptoms often confused with vertigo

Answer 2

faintness lightheadedness

Question 3

acronym for causes of vertigo

Answer 3

IMBALANCE Infection Injury Meniere’s Benign Paroxysmal Positional Vertigo Aminoglycosides Lymph, Peri, fistula Arterial Nerve Central lesions Epilepsy

Question 4

Infective causes of vertigo

Answer 4

labyrinthitis (post viral severe vertigo, n/v) Ramsay Hunt Syndrome T2

Question 5

Causes of Vertigo: Injury

Answer 5

trauma to petrous temporal bone

Question 6

Meniere’s

Answer 6

Endolymphatic hydrops- fluctuating levels of endolymph, which fills the vestibular/ cochlear instruments

Question 7

Causes of Vertigo: Benign Positional Vertigo

Answer 7

sudden vertigo for a few seconds provoked by head rotation-

Question 8

Pathology of a congenital fistula causing vertigo

Answer 8

Connection between inner and middle ears

Question 9

Causes of Vertigo: arterial

Answer 9

migraine TIA/Stroke

Question 10

Nerve related vertigo

Answer 10

acoustic neuroma vestibular schwannoma

Question 11

What type of seizure causes vertigo

Answer 11

complex partial

Question 12

What central lesion causes vertigo

Answer 12

lateral medullary syndrome (demylination / tumour infarct)

Question 13

How does vertigo caused by congenital fistula present

Answer 13

vertigo + SNHL

Question 14

Tullio’s phenomenon

Answer 14

nystagmus evoked/dizziness by loud sound sign of congenital fistula

Question 15

Diagnosis of BPPV

Answer 15

nystagmus on performing Hallpike-Dix manoeuvre

Question 16

Treatment of BPPV

Answer 16

Epley manoeuvre

Question 17

Ramsay Hunt syndrome Type 2

Answer 17

• reactivation of HZV in the geniculate ganglion - PC: LMN lesion of the facial nerve, deafness, vertigo, and pain

Question 18

Presentation of Menieres

Answer 18

Recurrent vertigo (~20min) ± n/v- Fluctuating SNHL Tinnitus- Aural fullness-

Question 19

Cause of BPPV

Answer 19

canalolithiasis- loose stones

Question 20

Management of Menieres

Answer 20

an antihistamine may be useful if prolonged If severe disease; vestibular organ ablation using gentamicin

Question 21

Which drug over dose could cause dizziness

Answer 21

aspirin

Question 22

Epley maneuver

Answer 22