Vestibular Dysfunction Flashcards

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1
Q

What are the 3 main causes of dizziness

A
  • Otologic
  • Neurologic
  • General medical
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2
Q

What are some(4) otologic causes of dizziness?

A

BPPV
Vestibular Neuritis
Superior Canal Dehiscence
Meniere’s

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3
Q

What are some (4) causes of neurologic dizziness?

A

Vertibrobasilar insufficiency
Stroke
Migrain
Low CSF

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4
Q

What are some (3) general medical causes of dizziness?

A

Low B12
Orthostatic Hypotension
Hypoglycemia

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5
Q

Discrepancy between systems involved in balance control can result in?

A

Nausea or dizziness

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6
Q

What are the three input mechanisms for balance?

A

Vision
Vestibular
Somatosensory

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7
Q

What is the ampulla?

A

The bulbous bony opening that houses the cupula

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8
Q

What is the bulbous bony opening that houses the cupula called?

A

The ampulla

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9
Q

What is the cupula?

A

Senso/sail that houses hair cells

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10
Q

What houses the hair cells?

A

Cupula

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11
Q

What are the names of the semi-circular canals?

A

Anterior
Posterior
Lateral (horizontal)

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12
Q

Issues in what structures may cause peripheral vestibular issues?

A

Vestibular apparatus
Vestibular portion of CN VIII
Cerebellopontine angle tumors

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13
Q

Issues in what structures may cause central vestibular issues?

A

Vestibular nuclie
Central pathways
Cerebellopontine angle tumors

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14
Q

What may cause both central and peripheral vestibular signs?

A

Cerebellopontine angle tumors

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15
Q

What are some peripheral vestibular diagnoses?

A
Acoustic neuroma
Meniere's disease
Gentamicin otolithic ablation
Guillain Barre
BPPV
Vestibular Neuritis
Perilymphatic Fistula
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16
Q

What is the most common cause of vertigo

A

BPPV

17
Q

What brings on episodes of BPPV?

A

Rapid change in head position

18
Q

Which gender gets BPPV more often?

A

Women

19
Q

How long does vertigo typically last in BPPV?

A

30 seconds - 2 min

20
Q

Is it common for BPPV to have spontaneous remission?

A

yes

21
Q

Can BPPV be reccurent

A

yes

22
Q

What is cupulolithiasis?

A

Otoconial material gets stuck in the cupula

Disrupts cupula’s response to gravity

23
Q

What is canalithiasis?

A

Otoconial debris gets into a semicircular canal

Creates a suction moment that acts on the cupula

24
Q

Which canal is more likely to be effected by canalithiasis, posterior or lateral?

A

posterior

25
Q

BPPV generally runs its course over a period of ________

A

6-12 months

26
Q

Are antiveriginous drugs effective against BPPV?

A

no

27
Q

If BPPV persists, an MRI may be indicated. Why?

A

To rule out acoustic neuroma, cerebellar, or 4th ventricle tumar

28
Q

What is the 2nd most common cause of vertigo?

A

Vestibular neuritis

29
Q

Vestibular neuritis is often associated with?

A

a virus

30
Q

What 2 types of infections often are concurrent of precede vestibular neuritis?

A

upper respiratory or GI

31
Q

What ages are most often affected by vestibular neuritis

A

30-60 yo.
women peak in 40’s
men peak in 60’s

32
Q

Vestibular neuritis has a _____ onset, with prolonged ______ vertigo, which increases with movement of _______

A

Acute
rotational
the head

33
Q

Vestibular neuritis is associated with…

A

horizontal-rotatory nystagmus
postural imablance
N&V

34
Q

How is vestibular neuritis managed?

A

Vestibular suppressants
Bedrest (24-72 hrs)
Gradual return to function

35
Q

How long does recovery from vestibular neuritits generally take?

A

6 weeks

36
Q

How can vestibular rehab speed recovery for vestibular neuritis?

A

slowly increase ambulation
general conditioning
gaze stabilization exercises
facilitate central compensation

37
Q

Meniere’s disease

A
Hereditary or sporadic
Distension of endolymphatic system
Damage to hair cells
Vestibular and auditory
Tinnitus and hearing changes
38
Q

How long does vertigo from meniere’s last, and what is it preceded by?

A

Lasts hours

Preceded by ear pressure/fullness

39
Q

Medical management of Meniere’s

A

Medication
Diuretics
Middle ear injections: gentamicin, steroids, sx

NO CURE