Vertigo Flashcards
what is vertigo
sensation that the room is spinning around you / sensation of movement
hallucination of movement
the duration of BPPV is sec/hr/days/variable
seconds
the duration of Menieres is sec/hr/days/variable
hours
the duration of vestibular neuronitis and labyrinthitis is sec/hr/days/variable
days
the duration of vestibular migraine is sec/hr/days/variable
variable
all dizziness is vertigo, true or false
false
list the systems that can cause dizziness
CVS Neuro ENT Ophtho DM Haem drugs anxiety
define dizziness
non-specific term which can cover vertigo, pre-syncope, dysequilibrium
dizziness symptoms in CVS disease
light headed
syncope
palpitations
dizziness symptoms in neurological disease
black out visual disturbance paraesthesia weakness speech and swallow disturbance
what should you ask in a history of dizziness
triggers time course associated symptoms - hearing loss, tinnitus, aural pressure, migraines precipitators alleviating factors medications
what is the top question for BPPV
do you get dizzy rolling over in bed
what is the top question for vestibular neuronitis
was your first attack severe lasting hours with N+V
what is the top question for vestibular migraine
do you get light sensitive with the dizzy spells
what is the top question for Menieres
does one ear feel full, do you notice a change to your hearing / tinnitus at the time of dizziness
examination of dizziness
otoscopy
BP + SLBP
Neuro
audiometry
what is BPPV
benign positional paroxysmal vertigo
very common
crystals from utricle become displaced in SCC
causes of BPPV
head trauma
ear surgery
idiopathic
triggers of BPPV
looking up head movements bending forwards getting out of bed rising from bed moving head too quickly
Dix-Hallpike test is diagnostic/therapeutic for BPPV
diagnostic
Dix - Diagnostic (D)
what treatments are available for BPPV
Epley manoeuvre
Semont
Brandt-Daroff
describe features of vestibular neuronitis / labyrinthitis
prolonged vertigo for days
viral aetiology
viral prodromal symptoms
tinnitus or hearing loss can be associated with vestibular neuronitis/viral labyrinthitis
viral labyrinthitis
management of vestibular neuronitis + viral labyrinthitis
self limiting
supportive
rest
vestibular sedatives/anti emetics - cyclizine, prochloperaxine, cinarazine
what is Menieres disease
unknown cause
? endolymphatic hydrops
Menieres is very common, true or false
false, it is uncommon
symptoms of Menieres
At least 2 episodes of recurrent rotational vertigo >20min Tinnitus precedes the attack Aural fullness SNHL on at least 1 occasion Other causes excluded
In Menieres, there is loss of high/low frequency hearing
low
Management of Menieres
supportive
tinnitus therapy
hearing aids
prevention - salt restriction, betahistine, caffiene, alcohol, stress
Intra-tympanic steroid ITS
Intra-tympanic gentamicin ITG
anti-emetics: bucastem - buccal prochloperazine
what is the most common auditory symptom in migraine
phonophobia
