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Pathologies > Vestibular Disorders > Flashcards

Vestibular Disorders Flashcards

1
Q

Balance System involves

A

Visual, proprioceptive and vestibular system

helps orient the body and head in space to maintain upright posture and maintain visual focus

feedback to a central system

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2
Q

vertigo

A

spinning or whirling of self or environment –

different than just lightheadedness, unsteadiness, loss of consciousness

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3
Q

Perilymph fistula

A

abnormal communication between air filled space of ME and perilymphatic space of inner ear

can occur at otic capsule, oval window or round window

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4
Q

Causes of Perilymph Fistula

A

stapedectomy, head trauma, barotrauma, chronic ear surgery, congenital anomalies, chronic OME, spontaneous rupture

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5
Q

Auditory symptoms of Perilymph fistula

A

sudden onset of HL, unilateral to a varying degree

SNHL, possibly mixed, LF HL

aural fullness and tinnitus

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6
Q

Perilymph Fistula vestibular symptoms

A

mild unsteadiness, motion induced vertigo, tullio’s sign: vertigo & nystagmus induced by loud sound

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7
Q

Perilymph Fistula treatment

A

bedrest 7-10 days, reduced activity, vestibular suppressants and perilymph fistula repair

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8
Q

Perilymph fistula prognosis

A

relieves vestibular symptoms more than it improves hearing, resolution of major symptoms for ~50% of patients (more so in individuals with an observed fistula)

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9
Q

Vestibular Neuritis/Labyrinthitis

A

Infection of inner ear/vestibular nerve resulting in sudden spontaneous vestibular loss

if there is only one vestibular nerve involved, vertigo results

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10
Q

Vestibular Neuritis/labyrinthitis symptoms

A

auditory: neuritis=no aud symptoms
labyrinthitis=HF SNHL

vestib: imbalance, disequilibrium, possibly vertigo, occasionally positional, horizontal beating nystagmus with torsional component, symptoms occur over a period of days-weeks

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11
Q

Vestibular neuritis/labyrinthitis ENG results

A

spontaneous horizontal nystagmus, gaze evoked nystagmus in horizontal plane, unilateral weakness on caloric test

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12
Q

VN/L treatment

A

symptom based medication

vestib rehab therapy to build up central compensation

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13
Q

VN/L prognosis

A

symptoms subside after a few weeks, once infection clears up symptoms should decrease significantly

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14
Q

Superior Canal dehiscence (SCD)

A

roof of superior semicircular canal is missing

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15
Q

SCD symptoms

A

tllio phenomenon, dizziness, pressure induced nystagmus, LF conductive HL, tinnitus, autophony

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16
Q

SCD differential diagnosis with otosclerosis

A

reflexes (present in SCD but not otosclerosis) and VEMPs, audio may have enhanced BC, CT scan

17
Q

SCD causes & trauma

A

slow erosion of bone, congenital, trauma

treated by resurfacing area, plugging superior canal

18
Q

Benign Paroxysmal Positional Vertigo (BPPV)

A

most inner ear disorder that causes dizziness

VIOLENT WHIRLING VERTIGO LASTING SECONDS TO MINUTES BROUGHT ON BY POSITIONAL CHANGE

~20% of all dizziness is due to BPPV, ~50% of all dizziness in older individuals is due to BPPV

19
Q

BPPV Cupuloithiasis & canalithiasis

A

particles adhere to cupula of SCC, indicated more in horizontal canal movement – vertigo is intense and persists while head is in provocative position

canalithiasis: free floating particles within SCC, sludge through canal and gravitate toward posterior canal

20
Q

BPPV Posterior SCC–Classic 4 signs

A
  1. Mixed torsional and vertical nystagmus with upper pole of eye beating toward affected ear and vertical nystagmus beating toward forehead
  2. Onset after maneuver-nystagmus typically appears after 1-2 sec latency, lasts only up to 30 sec
  3. Reversal of nystagmus direction upon return to sitting
  4. fatigue of response with repetition of maneuver
21
Q

BPPV Horizontal SCC

A

much less common than posterior, pt lies supine and head & body are quickly turned toward side being tested

purely horizontal nystagmus-generally beats toward undermost ear but in some cases can beat towards uppermost ear

22
Q

Possible causes of BPPV

A

idiopathic: 50-70%
secondary: 30-50% (head trauma, viral labyrinthitis, meniere’s disease, migranes, inner ear surgery)

no auditory symptoms

23
Q

BPPV Treatment/Rehab

A

spontaneous recovery without treatment, maneuevers, repositioning

surgical treatment: section posterior ampullary nerve, posterior SCC occlusion fixes cupula in place rendering it unresponsive to normal angular acceleration or to stimulation from free floating particles or those stuck in cupula

24
Q

Presyncope

A

“about to faint” feeling

25
Q

Vexion

A

feeling of moving through space

26
Q

Pulsion

A

feeling of being pushed or pulled

27
Q

Ataxia

A

gait problems

28
Q

diplopia

A

double vision

29
Q

oscillopsia

A

shaky vision

30
Q

lightheadedness

A

floating, walking on foam

31
Q

nausea

A

about to vomit feeling

Pathologies (5 decks)

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