vertigo Flashcards
head impulse test - expected finding in central vertigo
negative ie vertigo not triggered by head movement
head impulse test - expected finding in peripheral vertigo
positive ie vertigo triggered by head movement
head impulse test
- what reflex is tested
vestibulo-ocular reflex
head impulse test
- how to perform the test
- interpretation
- get patient to focus on your nose
- slowly move patient’s head away from centre
- rapid movement 5 degrees in opposite direction
- if eyes fail to track = peripheral lesion
- the direction of sudden turn = side where lesion is present
test of skew
- how to perform the test
- interpretation
cover 1 eye, then uncover it
if the eye has to wander back into position = central vertigo
vertigo triggered by movement
- ddx (5)
BPPV vestibular neuronitis labyrinthitis acoustic neuroma acoustic neuroma
vertigo triggered by vertical movement suggests what dx
BPPV
vertigo triggered by horizontal movement suggests what dx (2)
vestibular neuronitis, acute labyrinthitis
difference in presenting symptoms for vestibular neuronitis vs labyrinthitis
labyrinthitis has hearing loss
peripheral vertigo + hearing loss
- ddx (3)
labyrinthitis
meniere’s disease
acoustic neuroma
vertigo
- indications for MRI (4)
- you think its central
- CVA risk factors
- associated neuro signs
- vertigo with headache
nonmedical management of peripheral vertigo
- lifestyle (3)
- allied health (1)
restrict - salt - etoh - caffeine vestibular rehabilitation via physiotherapy
medical management of peripheral vertigo
- nausea
- nausea + vomiting
- meniere’s disease
stemetil 5-10mg PO TDS
stemetil IM 12.5mg stat, then PO 5-10mg in 6/24
hydrochlorothiazide 25mg PO OD