Vestibular Dysfunction Flashcards
What are the 3 main causes of dizziness
- Otologic
- Neurologic
- General medical
What are some(4) otologic causes of dizziness?
BPPV
Vestibular Neuritis
Superior Canal Dehiscence
Meniere’s
What are some (4) causes of neurologic dizziness?
Vertibrobasilar insufficiency
Stroke
Migrain
Low CSF
What are some (3) general medical causes of dizziness?
Low B12
Orthostatic Hypotension
Hypoglycemia
Discrepancy between systems involved in balance control can result in?
Nausea or dizziness
What are the three input mechanisms for balance?
Vision
Vestibular
Somatosensory
What is the ampulla?
The bulbous bony opening that houses the cupula
What is the bulbous bony opening that houses the cupula called?
The ampulla
What is the cupula?
Senso/sail that houses hair cells
What houses the hair cells?
Cupula
What are the names of the semi-circular canals?
Anterior
Posterior
Lateral (horizontal)
Issues in what structures may cause peripheral vestibular issues?
Vestibular apparatus
Vestibular portion of CN VIII
Cerebellopontine angle tumors
Issues in what structures may cause central vestibular issues?
Vestibular nuclie
Central pathways
Cerebellopontine angle tumors
What may cause both central and peripheral vestibular signs?
Cerebellopontine angle tumors
What are some peripheral vestibular diagnoses?
Acoustic neuroma Meniere's disease Gentamicin otolithic ablation Guillain Barre BPPV Vestibular Neuritis Perilymphatic Fistula
What is the most common cause of vertigo
BPPV
What brings on episodes of BPPV?
Rapid change in head position
Which gender gets BPPV more often?
Women
How long does vertigo typically last in BPPV?
30 seconds - 2 min
Is it common for BPPV to have spontaneous remission?
yes
Can BPPV be reccurent
yes
What is cupulolithiasis?
Otoconial material gets stuck in the cupula
Disrupts cupula’s response to gravity
What is canalithiasis?
Otoconial debris gets into a semicircular canal
Creates a suction moment that acts on the cupula
Which canal is more likely to be effected by canalithiasis, posterior or lateral?
posterior
BPPV generally runs its course over a period of ________
6-12 months
Are antiveriginous drugs effective against BPPV?
no
If BPPV persists, an MRI may be indicated. Why?
To rule out acoustic neuroma, cerebellar, or 4th ventricle tumar
What is the 2nd most common cause of vertigo?
Vestibular neuritis
Vestibular neuritis is often associated with?
a virus
What 2 types of infections often are concurrent of precede vestibular neuritis?
upper respiratory or GI
What ages are most often affected by vestibular neuritis
30-60 yo.
women peak in 40’s
men peak in 60’s
Vestibular neuritis has a _____ onset, with prolonged ______ vertigo, which increases with movement of _______
Acute
rotational
the head
Vestibular neuritis is associated with…
horizontal-rotatory nystagmus
postural imablance
N&V
How is vestibular neuritis managed?
Vestibular suppressants
Bedrest (24-72 hrs)
Gradual return to function
How long does recovery from vestibular neuritits generally take?
6 weeks
How can vestibular rehab speed recovery for vestibular neuritis?
slowly increase ambulation
general conditioning
gaze stabilization exercises
facilitate central compensation
Meniere’s disease
Hereditary or sporadic Distension of endolymphatic system Damage to hair cells Vestibular and auditory Tinnitus and hearing changes
How long does vertigo from meniere’s last, and what is it preceded by?
Lasts hours
Preceded by ear pressure/fullness
Medical management of Meniere’s
Medication
Diuretics
Middle ear injections: gentamicin, steroids, sx
NO CURE
