Week 8 Vestibular Pathologies Flashcards
is it in the central or peripheral NS that nuclei and higher centers recognize signals from both sides of the body and compares them with one another
central
what are some common patient reported complaints
dizzy lightheaded vertigo imbalance disequilibrium oscillopsia HA and migraine tinnitus and feeling off
dizziness: possible lesion locations in the peripheral
semicircular canals
otoliths
CN 8
cervical spine.
dizziness: possible lesion locations in the central
cerebellum
midbrain
pons
spinal cord
what is the difference in nystagmus between the central and peripheral
central: can be vertical, unidirectional, or multidirectional
peripheral: typically unidirectional, not vertical
in which (the central or peripheral) will you have tinnitus, and decreased hearing
peripheral, uncommon in central
brainstem lesion signs are associated with peripheral or central?
central
in which (central or perisperhal) is oscillopsia common
central or peripheral (unless lesion is bilateral)
what is benign paroxysmal positional vertigo (BPPV). what is it provoked by?
what is it the most common cause of?
otoconia are displaced from the macula, into the semicircular canal, so error signals are sent with changes in endolymph speed
provoked by changes in head position and gravity
most common cause of vertigo
what are the signs and symptoms of BPPV?
nystagmus,
vertigo
nausea and vomiting
what is the duration and treatment of BPPV
usually subsides in 2 minutes, and vestibular rehab
what is vestibular neuritis
vestibular nerve inflammation, caused by the reactivation of latent herpes simplex virus I
damage to the nerve from virus, and the signals are interrupted to the brain
what are the signs and symptoms of vestibular neuritis
vertigo, disequilibrium, spontaneous nystagmus, nausea. HEARING IS NOT AFFECTED
what is the duration and treatment for vestibular neuritis
last up to 3 days, improves over 2 weeks
treatment: meclizine for nausea and vomit and vestibular rehab
what is labyrinthitis
inflammation or swelling in the middle ear, caused by an ear infection or an upper respiratory tract infection of the flu.
what are the signs and symptoms of labyrinthitis
vertigo, spontaneous nystagmus, disequilibrium, nauseam fullness in the ear, lightheadedness.
what is the duration and treatment of labyrinthitis
weeks to months, and antibiotic or meds and vestibular rehab
what is Meniere’s disease
unknown, but associated with fluid pressure in the inner ear
what are the signs and symptoms of Meniere’s disease
fullness in ear tinnitus severe acute vertigo actue disequilibrium nausea and vomit hearing loss
what is the duration and treatment for meunière’s disease
recurrent episodes over 1-7 years, each lasting 30 min to 24 hours
treatment: diuretics, low sodium diet, gentamicin injection to impair contralateral labyrinth, surgery for nerve.
vestibular rehab isn’t great
what is a vestibular schwannoma (acoustic neuroma)
slow growing benign tumor surround the CN 8, form an overproduction of Schwann cells
what are the signs and symptoms of a neuroma
vertigo, nausea, possible progressive hearing loss
what is the duration and what is the treatment for a neuroma
surgery and vestibular rehab and symptoms last as long as tumor is there, or even after resection
what is a perilymph fistula
caused by head trauma, and sever pressure changes, leading to inner ear damage, causing fluid to leak between the inner and middle ear
what are the symptoms of perilymph fistulas
hearing loss, tinnitus, vertigo
what is the duration and treatment for perilymph fistulas
can be lifelong, and treatment requires referral to ENT, need decongestants, surgery.
do you have vertigo with unilateral or bilateral vestibular loss
unilateral
what are some vestibular disorders, health conditions for central problems
brain stroke or cerebellar stroke, migraine, TBI, concussion, neurodegenerative
where is the lesion with a central problem
in the vestibular nuclei, and in their connections to the brain
what are the causes of central vestibular disorders
stoke, concussion, TBI, tumor, atrophy, MS, PD, Arnold chiari malformation
if there is an infarct near the pons, what kind of results do you get
visual and vestibular deficits
if there is a lesion in the cerebellum, what are the results
spinocerebellar tracts, vestibulocerebellar tracts and severe imbalance and dizziness
if there is diffuse axonal injury what are we expecting
imbalance, double vision, many other symptoms
what is a vestibular migraine
combination of altered neural and vascular processes usually triggered by internal or enviro factors, pain receptors are activated in the brainstem, not far from the vestibular apparatus
what are the signs and symptoms of a vestibular migraine
visual or auditory aura dizziness nystagmus nausea light and sound sensitivity
what is the duration and treatment for vestibular migraines
duration is minutes to hours to days
treatment is PT and vestibular rehab and dietary changes, meds, behaviors and exercise
what is cervicogenic dizziness (non-vestibular)
abnormal afferent signals from the neck that create various sensations of altered orientation in space and equilibrium. PT very effective
what is anxiety related dizziness (mood or psychological and non-vestibular)
linkage between pain paths and vestibular paths and control of emotion and affect. lightheaded or woozy, and imbalanced. may need head doctor, meds, PT
what are some other central problems to worry about (non-vestibular)
orthostatic hypotension
B12 deficiency
vertebral artery insufficiency
hypoglycemia
