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Surgical Specialties: (ENT) Ear > Vertigo > Flashcards

Vertigo Flashcards

1
Q

What is vertigo?

A

An illusion of movement which includes a sensation of rotation of self or environment. As well as sensations of being pulled down/sideways.

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2
Q

What is dizziness?

A

Generic term referring to light-headedness, faintness, unsteadiness.

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3
Q

How can you identify ‘true’ vertigo in a history?

A

Patient will known exactly which way they were spinning/direction they were being pulled to.

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4
Q

What are the central causes of vertigo (brain)?

A
  1. Acoustic neuroma
  2. MS
  3. Head injury
  4. Migraine associated dizziness
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5
Q

What are the peripheral causes of vertigo (ear)?

A
  1. Meniere’s disease
  2. BPPV
  3. Vestibular failure
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6
Q

What is this a presentation of (vertigo)?

Usually vertical nystagmus, fast beat towards side of lesion, cerebellar signs, not relieved by gaze fixation.

A

Central cause of vertigo

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7
Q

What is this a presentation of (vertigo)?

Usually horizontal nystagmus, fast beat away from side of lesion, no cerebellar signs, relieved by gaze fixation.

A

Peripheral cause of vertigo

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8
Q

How is vertigo investigated?

A
  1. Otoscope
  2. Assess cranial nerves
  3. Test cerebellar function and reflexes - nystagmus, gait
  4. Consider audiometry and MRI
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9
Q

What is this a presentation of?

Attacks of sudden rotational vertigo lasting seconds to minutes, provoked by head turning.

A

Benign paroxysmal positional vertigo (BPPV)

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10
Q

What is the pathophysiology of vertigo?

A

Displacement of otoconia which stimulate the semi-circular canals, usually idiopathic.

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11
Q

What are the symptoms that need to be ruled out before diagnosing BPPV?

A
  1. No persistent vertigo
  2. No speech, visual, motor, or sensory problems
  3. No tinnitus, headache, ataxia, facial numbness
  4. No vertical nystagmus
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12
Q

What is the diagnostic test for BPPV?

A

Hallpike test

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13
Q

What is the curative treatment for BPPV?

A

Epley manoeuvre

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14
Q

What is this a presentation of?
Sudden attacks of vertigo lasting 2-4 hours, nystagmus present, aural fullness, tinnitus, sensorineural hearing loss, unilateral becoming bilateral.

A

Meniere’s disease

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15
Q

What is the pathophysiology of Meniere’s disease?

A

Excessive pressure and dilation of the endolymphatic system.

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16
Q

What is the management of Meniere’s disease?

A
  1. Acute - buccal prochlorperazine
  2. Prevention - PO betahistine
  3. Inform DVLA, stop driving until symptoms controlled
17
Q

What is this a presentation of?

Recurrent vertigo lasting hours or days, nausea and vomiting, horizontal nystagmus, no hearing loss or tinnitus.

A

Acute vestibular failure/vestibular neuronitis

18
Q

What is the cause of vertigo in acute vestibular failure/vestibular neuronitis?

A

Viral infection attacks vestibular ganglion

19
Q

What is the management of acute vestibular failure/vestibular neuronitis?

A

Short course of PO prochlorperazine

20
Q

What is this a presentation of?

Acute onset vertigo, nausea and vomiting, hearing loss (varying severity), and tinnitus.

A

Labyrinthitis

21
Q

What is labyrinthitis and what is it associated with?

A
  1. Inflammatory disorder of the membranous labyrinth

2. Preceding or concurrent URTI (usually viral)

22
Q

What is the management of labyrinthitis?

A

Short course of PO prochlorperazine

23
Q

What are the causes of a post-traumatic vertigo?

A
  1. BPPV or vestibular migraine

2. Temporal bone fracture

24
Q

What is this a presentation of?

Acute head injury, unilateral deafness, CN VII palsy, vertigo.

A

Temporal bone fracture

25
Q

What is the most common finding in the acute phase of post-traumatic vertigo?

A

Central vestibular gait apraxia

26
Q

What is multisensory dizziness syndrome?

A

Reduced inputs from more than one sensory system.

27
Q

What is this a presentation of?
Reduced visual acuity (cataract/glaucoma), peripheral neuropathy (reduced proprioception), impaired hearing, elderly/diabetes mellitus patient.

A

Multisensory dizziness syndrome

Surgical Specialties: (ENT) Ear (15 decks)

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