WEEK 2: Dizziness and Vertigo [Doc Salonga] NOT INCLUDED YET Flashcards
A sensation of lightheadedness, faintness, or unsteadiness; does not involve a rotational component.
Dizziness
The perception of movement or whirling, either of the self or surrounding objects.
Vertigo
Unsteadiness, imbalance, or loss of equilibrium, often accompanied by disorientation
Disequilibrium
A sensation of not knowing where one’s body is in relation to the vertical or horizontal planes
Spatial Disorientation
Lesion in the posterior fossa, anong test ang gagawin? CT or MRI?
MRI kasi nahahaharangan siya doon pag posterior fossa.
T or F? Dizziness does not involve a rotational
component.
T
have patient lie back on
examining table so that head hangs over edge at 30° below
horizontal. Do not move patient into this position too quickly.
Then have patient look straight ahead and watch for 30
seconds. If nystagmus and vertigo develop, note directions of
fast and slow phases and ask patient to describe sensations
Nylen-Barany Maneuver
in nylen barani, If vertigo
lasts longer than 60 seconds in this position, it is
called
persistent positional vertigo. if not, then, transient positional vertigo
if there is a positive sign in head thrust test, with a saccade back to the target, what does it indicate?
ipsilateral vestibular lesion
in head shaking test, where is the nystagmus if there is a bilateral vestibular loss?
NONE. no nystagmus
Unilateral vestibular neuritis or acoustic neuroma, where is the location of the nystagmus?
basta always going towards the better ear.
First phase nystagmus- where is the location of the nystagmus?
the nystagmus will be away from
the lesion.
If it is a problem with the connection of the vestibular system
with the cerebellum, then the nystagmus will be
bidirectional.
Down beat nystagmus- not associated with vestibular lesions. T or F?
T
if it persists and is not episodic then that is not considered as BPPV T or F?
T
rapid phase nystagmus what direction? slow pahse? environment? romberg’s sign?
rapid is away
slow phase is toward
environment is spinning away from lesion
Romberg’s sign toward the lesion
give some of the red flags in patients with vertigo
double vision headache weakness diff speaking diff waking up or staying awake diff walking inapp actions diff controlling arms or legs abnormal eye movements
describes symptoms of dizziness and/or disequilibrium that arise from neck pain and issues that include cervical trauma, cervical arthritis, and other causes.
cervicogenic dizziness
is a skin growth that occurs in the middle ear behind the eardrum that can invade the surrounding skull and inner ear, thus causing lots of destruction.
Cholesteatoma
caused by exposure to certain drugs or chemicals (e.g., intra-venous aminoglycoside antibiotics) that damage the inner-ear nerve hair cells or the vestibulo-cochlear nerve.
Ototoxicity
inflammations caused by a viral infection that can result in damage to hearing and vestibular function
Labyrinthitis; vestibular neuritis
is a sensation of rocking or movement that persists after a cruise or other form of travel.
Mal de débarquement
primary endo-lymphatic hydrops, involves abnormal-ities in quantity, composition, or pressure of the endolymph (one of the fluids within the inner ear). It is a progressive condition.
Meniere’s Disease
may be characterized by head pain with symptoms associated with vestibular impairment such as dizziness, motion intolerance, spontaneous vertigo, sensitivity to light and sound, tinnitus, imbalance, and spatial disorientation.
Migraine associated vertigo
what are the peripheral cochlear lesions? (4)
labyrynthitis, vestibular neuritis, meniere’s disease, and BPPV.
is thought to be a result of viral infection of the endolymph and perilymph affecting both the vestibular and cochlear components of the system.
• The usual history is viral illness followed by acute onset of severe spinning vertigo and sensory neural deafness with tinnitus.
Labyrinthitis
hought to be pathogenetically identical to labyrinthitis but without any hearing symptomatology.
Vestibular neuritis
If the patient has vertigo unaccompanied by a hearing abnormality, it is strictly speaking impossible to be sure whether the disease is cochlear or retrocochlear. T or F?
T
classically characterized by a dull ache in the region of the mastoid process or around the ear associated with severe tinnitus, a cochlear kind of sensory neural hearing loss, and a classic peripheral type of vestibular syndrome with severe spinning vertigo.
Meniere’s Disease
a nonspecific sign of auditory system disorder, is a major problem for patients with meniere’s disease, who can be terribly disabled for weeks at a time by the vertigo that accompanies acute attacks
Tinnitus
common in older people, especially those with circulatory problems and diabetes. When a person has low blood pressure and pooling of blood in the lower part of the body while sitting or lying down, the process of standing up quickly can cause dizziness and fainting. Normally, body reflexes accommodate such position changes.
Orthostatic Hypotension
is a joint disease that can narrow the openings in the neck vertebrae (bones) through which blood vessels flow. Blockage of these vertebral arteries results in an inadequate blood supply to the base of the brain or brainstem—where the balance information is controlled.
Cervical osteoarthritis;
yung symptoms nya na dizziness and lightheadedness, yun yung termed as vertebrobasilar insufficiency
is a nervous-system response that causes sudden loss of muscle tone in peripheral blood vessels.
vasovagal syndrome
main receptors in the vestibular nuclei
cholinergic and histmainergic
A mismatch of sensory input from the vestibular, visual and proprioceptive systems produces vertigo T or F?
T
stimulation of vomiting center what neurotransmitter?
histaminergic
inhibits vestibular activity (from brainstem to the vestibular nuclei) what neurotransmitter?
noradrenergic
inhibits cerebellar Purkinje cells what neurotransmitter?
GABAergic
vertigo occuring only during head motion?
head motion vertigo
false sensation that the visual surround is spinning or flowing.
External Vertigo
major side effect of vertigo drugs?
major sedation
longest duration of activity in vertigo drugs?
piperazines, Meclizine
subcutaneous route drug for vertigo?
scopolamine
