Vestibular Desorders

Question 1

It´s the most commun Vertibular desases, Px 50 yo apreing while px go next to his bed and has vertigo (Just 10-30 seconds) without hearing lost (No tiene) & and has nistagmo.

que dx sospecha?

Answer 1

Bening Paroxystic Positional Vertigo. (BPPV)

Question 2

Whats the phisiophatology or BPPV?

Answer 2

Cpololithiasis & Canalolitiasis (Al moverse el canal semicircular genera las debridas ).

Question 3

Whats the BPPV Dx with?
To confirm it

Answer 3

1° Make Dix-Hallpike Test
2°MRI = Neruological Asociation
3°Audiogram = Has No Hearing Loss

Question 4

Whats the BPPV Tx? & Qx?

Answer 4

Epley & Semont maneuver

En caso de recurrencia:
*Qx: Mastoidectomy (Posterior semicircular canal oclusion)

Si no se cura aun con la tecnica… Qx.

Question 4

Whats the Triada Dx of BPPV

Answer 4

Old man
Vertigo (10-20 seconds)
Nistagmus

Question 5

Px Sudently satarted to loss hearing by a concert or pool party (rally hught noise), then got vertigo (Lasting 50 minutes) & tinittus + aural presure. Nauseas and Vomiting

Whats the dx?

Answer 5

Meniere Disease

Jamas hacer Timpanometria

Question 6

Whats Meniere Disease Idea of deseas?

Answer 6

Increes of Endolinfatic Liq (Without reabsorcion) –> Makes obstruccion ang generet vertigo + Hearing loss + nausea .

Question 7

What can U use or make to confirm Meniere Disease?

Answer 7

Audiometry testing + FTA -ABS

Question 8

Whats de Manengment of Meniere Disease ? (Remember has no cure)

Answer 8

Aminoglycoside Therapy.
Low Sodium
Diuretics
Antiemetics

Question 9

What are some of Curgery you make do on Meniere Disease?

Answer 9

Endolymphatic SAC Surgery. | Vestibular Nerve Section | Labyrunectomy.

(Reserch)

Question 9

37 yo Female px who has recently viral infection presents Vertigo + Nauses/ Vomiting and spontaneus nistagmus.
you make her Vestibular testing

What kinda of Viral infection makes this Desease?

What Imagen study would you make for her?
(Why?)

Dx + Tx?

Answer 9

Pueden empeorar a BPPV

Made by Herpes Simplex Virus type 1 (HSV-1)

Make a 1°MRI (Hemorragycal cerebellar stroke) then 2°CT

Dx: Vertibular Neuritis
Tx: Vestibular Suppressants + Antiemetics.

Question 9

12 yo male px come to consult cause he feels hearing loss and vertigo with punsatil tinnitus , he coments that hears himself (Autopgony), we make the CH & it happends when he make a hard pull (Pujar) … you make him Maniobra de valsalva to change presure ant has the simtoms again…

whats the i dx?

Answer 9

SUPERIOR SEMICIRCULAR CANAL DEHISCENCE (SSCCD)

Question 10

12 yo male px come to consult cause he feels hearing loss and vertigo with punsatil tinnitus , he coments that hears himself (Autopgony), we make the CH & it happends when he make a hard pull (Pujar) … you make him Maniobra de valsalva to change presure ant has the simtoms again…

Whats the Tx and Signus looks at CT-Scan

Answer 10

CT-Scan: Pöschl view with 0.5­mm

Tx: Avoid Loud Noise, Do Singind/ Jogging (Run Slowly)

Qx: tympanostomy tube (of superior semicircular canal dehicence.).

same as OME