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ENT > Vertigo > Flashcards

Vertigo Flashcards

1
Q

What is vertigo?

A

false sensation that the body or environment is moving

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2
Q

What are peripheral causes of vertigo?

A 
BPPV
Menieres disease
Vestibular neuronitis 
Labyrinthitis
Cholesteatoma
Acoustic neuroma
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3
Q

What are central causes of vertigo?

A

Migraine
Stroke/TIA
Cerebellar tumour
MS

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4
Q

What features suggest a peripheral cause?

A

Can walk
May have hearing loss or tinnitus
NO neurological sx
Horizontal nystagmus, beats away from affected side, disappears w fixation of gaze

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5
Q

What features suggest a central cause?

A
  • Hearing loss and tinnitus less common
  • Nystagmus can be vertical
  • Unable to stand up or walk with eyes open
  • usually have neurological sx
  • Less severe
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6
Q

Wat exams and tests would u do/

A
  1. Assess CNS and ears
  2. Test cerebellar function + reflexes
  3. Nystagmus? gait? rombergs?
  4. head thrust test
  5. Dix hallpike test
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7
Q

how long does vertigo last for in BPPV?

A

<30 seconds/1 min

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8
Q

What brings on vertigo in BPPV?

A

head turning

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9
Q

explain the pathology behind BPPV

A

displacement of otoliths in semicircular canals

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10
Q

what causes BPPV?

A

idiopathic
middle ear disease
otosclerosis
head injury

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11
Q

what are important negatives to rule out in BPPV?

A
  • persistent vertigo
  • speech, visual, motor or sensory problems
  • tinnitus, headache, ataxia, facial numbness or dysphagia
  • vertical nystagmus
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12
Q

What is the treatment of BPPV?

A

usually self limiting

Epley manœuvre

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13
Q

What is the underlying pathology in menieres?

A

dilatation of endolymphatic spaces of membranous labrynth

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14
Q

What are the features of menieres?

A

sudden attacks of vertigo for 2-4hrs
nystagmus ALWAYS present
increased feeling of fullness in ears +/- tinnitus followed by vertigo
fluctuating sensorineural hearing loss

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15
Q

how is menieres diagnosed?

A

electrocochleography

MRI of endolymphatic space

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16
Q

what is the treatment of menieres disease?

A

prochlorperazine
betahistine
chlortalidone

17
Q

what causes of vertigo typically follow a viral infection?

A 
viral labyrinthitis 
vestibular neuronitis (acute vestibular failure)
18
Q

how does vestibular neuronitis present?

A

recurrent sudden vertigo attacks lasting hrs or days
N+V
horizontal nystagmus
no hearing loss or tinnitus

19
Q

what is the treatment of vestibular neuronitis?

A

Vestibular rehabilitation exercises for chronic
Buccal/IM prochlorperazine - rapid relief when severe
Antihistamine - cyclizine

20
Q

how does vertebrobasilar ischaemia typically present?

A

elderly

dizziness on extension of neck

21
Q

What is the labyrinth made up of ?

A

cochlear and semicircular canals

22
Q

what is the character of the nystagmus in vestibular neuronitis?

A

horizontal away from affected side

ENT (19 decks)

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