Vertigo - Ear Causes

Question 1

Summary of the ear causes of vertigo

Answer 1

BPPV

Menieres

Vestibular Neuritis

Labyrinthitis

Question 2

What are the symptoms of Benign Paroxysmal Positional Vertigo?

Answer 2

Vertigo for a few seconds when moving in a certain way, such as rolling over in bed.

Question 3

What is the cause of BPPV?

Answer 3

Otoconia moving from the macula to the cupula

Question 4

How is BPPV diagnosed?

Answer 4

Dix Hallpike test

The presence of rotational nystagmus

Question 5

How is BPPV treated?

Answer 5

Epley maneuvre

Question 6

What are the symptoms, causes, diagnostic test and treatment for BPPV?

Answer 6

Symptoms - Seconds of vertigo when moving a certain way

Causes - Movement of otoconia

Diagnostic test - Dix-Hallpike

Treatment - Epley Maneuovre

Question 7

What are the symptoms of Menieres disease?

Answer 7

Vertigo for hours to a day

Tinnitus

Nausea and Vomiting

Question 8

What is the cause of Menieres disease?

Answer 8

Stenosis of the endolymphatic duct and eventual bursting causing the symptoms.

It resolves once the burst has been drained, hence the up to a day symptoms

Question 9

How is Menieres diagnosed?

Answer 9

Via the history or an audiology test during an episode

Question 10

What is the conservative treatment for Menieres?

Answer 10

Reduce salt intake

Question 11

What is the medical treatment for Menieres?

Answer 11

Beta histines - They dilate blood vessels to promote drainage

Question 12

What is the surgical treatment for Menieres?

Answer 12

1. Grommets
2. Vestibular nerve cutting
3. Gentamycin to kill off vestibules
4. Decompress endolymph

All preserve hearing

1. Labyrinthectomy

Lost hearing

Question 13

What are the symptoms, cause, diagnostic tool and treament for Menieres?

Answer 13

Symptoms - Vertigo up to a day, tinnitus and hearing loss, nausea and vomiting

Cause - Burse endolymphatic duct

Diagnostic tool - History or audiology on attack

Management - Conservative, low salt. Medical, beta histines. Surgical, grommets, gentamycin, decompression, vestibular nerve cutting, labyrinthectomy

Question 14

What is vestibular neuritis and what are the symptoms?

Answer 14

Inflammation of the vestibular nerve

Symptoms - Vertigo for days and weeks, nausea, vomiting, pallow. No hearing loss

Question 15

What can be the cause of vestibular neuritis?

Answer 15

Viral infection eg. Herpes

Vascular occlusion

This takes weeks to resolve hence the timescales

Question 16

How is vestibular neuritis managed?

Answer 16

Rehab and waiting.

Vestibular sedatives like prochloroperazine can help

Question 17

What are the symptoms, cause and treatment for vestibular neuritis?

Answer 17

Symptoms - Vertigo for weeks, nausea, vomiting.

Cause - Infection, ischaemia

Treatment - Rehab, vascular sedatives like prochloroperazine

Question 18

What is labyrinthitis and what are the symptoms?

Answer 18

Inflammation of the membranous labyrinthe

Symptoms - Vertigo for weeks, hearing loss and tinnitus, nausea, vomiting, pallor, sweating

TINNITUS USUALLY PERMANENT

Question 19

What are the causes of labyrinthitis?

Answer 19

Infection

Ischamia.

It takes time for the vestibules to compensate, hence the time frame

Question 20

What is the treatment for labyrinthitis?

Answer 20

Rehab

Vestibular suppressants - Prochloroperazine

Question 21

What are the symptoms, causes and treatment of labyrinthitis and what is one long term permanent effect?

Answer 21

Symptoms - Vertigo, tinnitus, hearing loss, sweating, nausea, vomiting, diarrhoea, pallor.

Causes - Infection, ischaemia

Treatment - Rehab, prochloroperazine

Long term effect - Permanent deafness