Vertigo

Question 1

What is dizziness?

Answer 1

A general, non-specific term to indicate a sense of disorientation

Question 2

Is vertigo the same as dizziness?

Answer 2

No, vertigo is a type of dizziness

Question 3

What is vertigo?

Answer 3

A false sensation that oneself or the surroundings are moving or spinning

Question 4

What is vertigo usually accompanied by?

Answer 4

• Nausea

- Loss of balance

Question 5

What is vertigo the result of?

Answer 5

Mismatch between the vestibular, visual and somatosensory systems

Question 6

What groups can the causes of vertigo be subdivided into?

Answer 6

• Central (cerebral cortex, cerebellum and brainstem)

- Peripheral (vestibular labyrinth, semicircular canals or vestibular nerve)

Question 7

What are the central causes of vertigo?

Answer 7

• Cerebrovascular disease
• Migraine
• MS
• Acoustic neuroma
• Diplopia
• Alcohol intoxication

Question 8

What are the peripheral causes of vertigo?

Answer 8

• Viral labyrinthitis
• Vestibular neuritis
• BPPV
• Meniere’s disease
• Motion sickness
• Ototoxicitiy
• Herpes zoster (Ramsay Hunt)

Question 9

What drug can cause ototoxicity?

Answer 9

Gentamicin

Question 10

What does BPPV stand for?

Answer 10

Benign paroxysmal positional vertigo

Question 11

What are the risk factors for vertigo?

Answer 11

• Older age

- Past episodes of dizziness

Question 12

What sensation is experienced in vertigo?

Answer 12

Spinning whilst stationary

Question 13

What other symptoms is vertigo commonly associated with?

Answer 13

• Nausea
• Vomiting
• Unsteadiness
• Falls
• Changes to person’s thought
• Difficulty walking

Question 14

In what time frame can the symptoms of vertigo present?

Answer 14

• Insidious (persistent)

- Sudden (episodic)

Question 15

What investigations are performed in primary care for ?

Answer 15

Usually none

Question 16

What investigatiosn can be performed for vertigo in secondary care?

Answer 16

• Audiometry
• Dix-Hallpike manoeuvre
• Electronystagmography
• CT or MRI
• EEG
• LP
• Syphilis serology

Question 17

What is audiometry used for when testing for vertigo?

Answer 17

Assessing cochlear function

Question 18

What is Dix-Hallpike used for in assessing vertigo?

Answer 18

Testing for BPPV

Question 19

What can a CT or MRI be used to look for in a patient with vertigo?

Answer 19

Neurological causes

Question 20

Why may an EEG be useful in assessing a patient with vertigo?

Answer 20

To look for epilepsy

Question 21

What can an LP look for in a patient with vertigo?

Answer 21

MS

Question 22

What are the differentials for vertigo?

Answer 22

• Postural hypotension
• Pre-syncope
• Non-specific dizziness
• Disequilibrium

Question 23

What is disequilibrium?

Answer 23

When the brain receives inadequate information about the body’s position from the somatosensory, visual, and vestibular systems

Question 24

What can cause disequilibrium?

Answer 24

• Peripheral neuropathy
• Eye disease
• Peripheral vestibular disorders

Question 25

What does the management of vertigo depend upon?

Answer 25

The underlying cause

Question 26

What general advice should be given to patients with vertigo?

Answer 26

• Don’t drive when dizzy or if likely to be dizzy
• Inform employer if dizziness makes work dangerous
• Discuss risk of falling and discuss measures to reduce this

Question 27

What does the DVLA say with regards to vertigo?

Answer 27

People who are liable to sudden unprovoked attacks of disabling dizziness should stop driving

Question 28

What drugs could be useful in managing associated symptoms of vertigo?

Answer 28

• Prochlorperazine

- Cyclizine

Question 29

What are the potential complications of vertigo?

Answer 29

• Increased risk of falls
• Confinement to home
• Depression