Vertigo Flashcards
What is Vertigo?
- describes a sense of movement and rotation of oneself or the surrounding environment
- typically a sensation of spinning, but can also present as linear motion or falling
- may have a peripheral or central origin
What are some characteristics of peripheral vertigo?
- episodic and short duration
- autonomic symptoms present
- precipitating factor
- pallor, sweating
- nausea and vomiting
- auditory fullness (fullness writhing ears)
- TINNITUS
What are some characteristics of central vertigo?
- autonomic symptoms—less severe
-loss of consciousness can occur
-neurological symptoms present including:
A. diplopia
B. Hemianopsia
C. Weakness
D. Numbness
E. Ataxia
F. dysarthria
What is the etiology of Peripheral vertigo?
- Benign paroxysmal positional vertigo (BPPV)
- Ménière’s disease
- Infection
- Trauma/tumor
- Metabolic disorders (diabetes mellitus)
- Acute alcohol intoxication
What is the etiology of Central Vertigo?
- Meningitis
- Migraine headache
- Complications of neurologic origin post ear infections
- Trauma/tumor
- Cerebellar degeneration disorders (i.e. alcoholism)
- Multiple sclerosis (MS)
What is Benign paroxysmal positional vertigo (BPPV) comprised of?
Comprised of repeated episodes of vertigo that occur subsequent to changes in head position
Describe BBPV
- Only lasts a few seconds and is typically first noted while in a recumbent position since it most commonly affects the posterior semicircular canal
- Nystagmus is present and can be noted using the Dix-Hallpike
What is the etiology of BPPV?
Usually otoconia (carnalith) that loosens and travels into the posterior semicircular canal, causing vertigo.
What is the treatment for BPPV?
Treated with carnality repositions maneuvers which are passive movements used to remove the otoconia from the canals, thus remediating vertigo
What is the Dix-Hallpike test?
Maneuver that is a vertiginous position test used in assessment and treatment
What does the Dix-Hallpike test stimulate?
Stimulates the posterior semicircular canal and attempts to determine if otoconia exist within the canal
What is Dix-hallpike test used for?
If pt experiences nystagmus and vertigo, the test is performed to determine if a pt presents with BPPV or a central lesion
Steps of the Dix-Hallpike
- Pt in long sitting w/ head rotated 45 degrees to one side
- Pt is rapidly moved to a supine position w/ the head (still in 45 degrees rotation) extended 30 degrees beyond horizontal off the end of the table
- PT continues to hold the pt’s head in this position for 20-30 seconds observing the potential nystagmus (direction and appearance can determine inner ear vs CNS lesion)
What is a Nystagmus?
- Abnormal eye movement that entails nonvolitional, rhythmic oscillation of the eyes
- Speed of movement is faster in one direction than the other direction
- Pts with Nystagmus often complain of vertigo, nausea, and oscillopsia
When observing Nystagmus what should the PT be observing?
Eye movement: Horizontal, vertical, rotatory or mixed movements
Type of eye movement: Pendular or jerk
Direction: Bidirectional or unidirectional
Nystagmus movement: Binocular or monocular with symmetrical or dissociated movement. Effects of change of position of the head or posture on Nystagmus