Vestibular Dysfunctions

Question 1

A 40yo male presents with episodes of vertigo that last several hours. The patient describes a feeling of fullness in the ear, tinnitus, and an inability to hear low-frequency sounds all in the right ear only. What is the likely diagnosis?

Answer 1

Meniere’s Disease

Question 2

Migraine with aura are typically due to what cause?

Answer 2

Ischemia of the basilar artery

Question 3

This type of vertigo is due to bacterial or viral origin, may involve hearing loss or tinnitus, and persists without movement.

Answer 3

Viral Labyrinthitis

Question 4

What is the clinical presentation of Benign Paroxymosyl Positional Vertigo?

Answer 4

Latent onset, short duration, nausea, mild postural instability, typically unilateral symptoms, more common in women

Question 5

True/False. Nystagmus is named for the direction of rapid eye movement.

Answer 5

True. The fast component is pathological. The slow component is the correction

Question 6

This class of antibiotics is known to be ototoxic.

Answer 6

Aminoglycosides (gentamycin, tobramycin, streptomycin)

Question 7

What commonly used chemotherapeutic and immunosuppressive drugs are known to be ototoxic?

Answer 7

Cisplatin, Carboplatin, Methotrexate

Question 8

What is the cause of Benign Paroxymosyl Positional Vertigo?

Answer 8

Debris from the canals fall into the semicircular canal. The posterior canal is most commonly involved

Question 9

What are the two types of migranes?

Answer 9

Migraine with and without aura

Question 10

True/False. Migraines must involve headache.

Answer 10

False. Migraines may or may not involve headaches

Question 11

How can Viral Labyrinthitis and Vestibular Neuritis be differentiated?

Answer 11

Vestibular Neuritis does not involve hearing loss or tinnitus and may only involve one attack

Question 12

What is the cause of Meniere’s Disease?

Answer 12

Distention of the membranous labyrinth and cochlear duct due to excess endolymph production or poor reabsorption

Question 13

How can serve vertigo be treated?

Answer 13

Benzodiazepines - used acutely to promote adaptation. This is regardless of type of vertigo

Question 14

A patient presents to the clinic with migraine, vertigo, and nystagmus. The nystagmus does not fatigue after several minutes and changes directions with different positions. What is the likely diagnosis?

Answer 14

This is likely due to a central disorder. Nystagmus due to BBPV fatigues and does not change direction

Question 15

How can peripheral and central vertigo be differentiated?

Answer 15

Peripheral vertigo involved auditory symptoms, nausea, and vomiting. Central vertigo is associated with neurological symptoms, diplopia, weakness, numbness, and poor coordination