Vertigo Flashcards
Define
The perception that the world is spinning in relation to one-self or vice-versa
Differential?
- Benign positional vertigo
- Menieres disease
- Vestibular neuritis
- Migraine
What is benign positional vertigo?
Otoconia in the semicircular canals of the ear (presence of bio-crystals usually found in the utricle which stimulate the cupula)
What is the presentation of benign positional vertigo
- Vertigo associated with head rotation movements
- Nystagmus (involuntary eye movement) which is positional and rotational
- Can last seconds
Investigation of BPV
Dix-hallpike test
Management of BPV
Epley manœuvre : relocation of the bio-crystals in the semicircular canals back to the utricle
What is menieres disease?
Endolymphatic hydrops i.e. distended end-lymphatic space
Presentation of menieres disease?
- Spontaneos vertigo
- Lasts hours
- Associated with unilateral hearing loss, tinnitus and aural fullness
Treatment for menieres
- Bendroflumethazide
- Intratympanic dexamethasone
- Intratympanic gentamycin
What are the causes of vestibular neuritis/ labyrinthitis?
Reactivation of the HSV virus in the vestibular ganglion
Presentation of VN?
- Spontaneous vertigo
- Lasts days
- Nyasgmus - horizontal towards affected ear
- Unilateral hearing loss
Management of VN?
Acute: vestibular sedatives
Chronic: Vestibular rehabilitation
What can be the causes of migraine?
Related to vascular or neurological problems
Presentation of migraines?
- Spontaneous vertigo
- variable duration
- can present with a headache
- Precipitated by triggers
- Previous history of migraines
Management of migraines?
Prophylactic treatment
Avoid triggers
