Vertigo, Dizziness, Headaches Flashcards
causes of “dizziness”
- vertigo (“room spinning”, neurologic)
- pre-syncope/ lightheadedness (cardiac)
-stroke, cerebellar problems
types of vertigo
- central
- peripheral = more common; Cr VIII or inner ear
central vertigo causes
- stroke (infarct of cerebellum, Cr VIII nucleus)
- MS (young pt)
- phenytoin toxicity (nystagmus + ataxia + vertigo)
- cerebellar or brain-stem tumor
peripheral vertigo px
- hearing loss
- tinnitus
- nystagmus (stops when you fixate on something)
central vertigo px
-focal neurological findings
(diplopia, dysarthria, weakness/ numbness)
-nystagmus (does NOT stop with fixation on object)
phenytoin toxicity px
- mild: horizontal nystagmus
- severe: vertical toxicity
- ataxia
- vertigo
- no therapy
benign positional vertigo px
BPV
- ONLY VERTIGO*
- occurs when you go from a lying to sitting position
-no tinnitus, hearing loss
Meniere’s disease
- hearing loss + tinnitus + vertigo
- short duration, but RECURRENT* episodes
acoustic neuroma px, dx, tx
- Schwannoma/tumor of Cr VIII
- ataxia*
- hearing loss
- CT, MRI
- surgery
labyrinthitis
- hearing loss + tinnitus + vertigo
- SINGLE* episode after recent viral illness
perilymphatic fistula
- trauma* to ear history
- hearing loss
types of peripheral vertigo
- Meniere’s disease
- labyrinthitis
- benign paroxysmal positional vertigo
- perilymphatic fistula
peripheral vertigo tx
- meclizine (=antihistamine) = best initial
- odansetron
benign positional vertigo tx
-head maneuvers to dislodge ear stones (otoliths) in semicircular canals
labyrinthitis tx
- meclizine
- viral infection of inner ear which is self-resolving
