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Clinical Neuroscience > Week 8 Vestibular Pathologies > Flashcards

Week 8 Vestibular Pathologies Flashcards

1
Q

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

A

central

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2
Q

what are some common patient reported complaints

A 
dizzy 
lightheaded
vertigo
imbalance
disequilibrium
oscillopsia 
HA and migraine
tinnitus and feeling off
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3
Q

dizziness: possible lesion locations in the peripheral

A

semicircular canals
otoliths
CN 8
cervical spine.

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4
Q

dizziness: possible lesion locations in the central

A

cerebellum
midbrain
pons
spinal cord

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5
Q

what is the difference in nystagmus between the central and peripheral

A

central: can be vertical, unidirectional, or multidirectional
peripheral: typically unidirectional, not vertical

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6
Q

in which (the central or peripheral) will you have tinnitus, and decreased hearing

A

peripheral, uncommon in central

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7
Q

brainstem lesion signs are associated with peripheral or central?

A

central

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8
Q

in which (central or perisperhal) is oscillopsia common

A 
central 
or peripheral (unless lesion is bilateral)
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9
Q

what is benign paroxysmal positional vertigo (BPPV). what is it provoked by?
what is it the most common cause of?

A

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

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10
Q

what are the signs and symptoms of BPPV?

A

nystagmus,
vertigo
nausea and vomiting

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11
Q

what is the duration and treatment of BPPV

A

usually subsides in 2 minutes, and vestibular rehab

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12
Q

what is vestibular neuritis

A

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

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13
Q

what are the signs and symptoms of vestibular neuritis

A

vertigo, disequilibrium, spontaneous nystagmus, nausea. HEARING IS NOT AFFECTED

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14
Q

what is the duration and treatment for vestibular neuritis

A

last up to 3 days, improves over 2 weeks

treatment: meclizine for nausea and vomit and vestibular rehab

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15
Q

what is labyrinthitis

A

inflammation or swelling in the middle ear, caused by an ear infection or an upper respiratory tract infection of the flu.

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16
Q

what are the signs and symptoms of labyrinthitis

A

vertigo, spontaneous nystagmus, disequilibrium, nauseam fullness in the ear, lightheadedness.

17
Q

what is the duration and treatment of labyrinthitis

A

weeks to months, and antibiotic or meds and vestibular rehab

18
Q

what is Meniere’s disease

A

unknown, but associated with fluid pressure in the inner ear

19
Q

what are the signs and symptoms of Meniere’s disease

A 
fullness in ear
tinnitus 
severe acute vertigo 
actue disequilibrium 
nausea and vomit 
hearing loss
20
Q

what is the duration and treatment for meunière’s disease

A

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

21
Q

what is a vestibular schwannoma (acoustic neuroma)

A

slow growing benign tumor surround the CN 8, form an overproduction of Schwann cells

22
Q

what are the signs and symptoms of a neuroma

A

vertigo, nausea, possible progressive hearing loss

23
Q

what is the duration and what is the treatment for a neuroma

A

surgery and vestibular rehab and symptoms last as long as tumor is there, or even after resection

24
Q

what is a perilymph fistula

A

caused by head trauma, and sever pressure changes, leading to inner ear damage, causing fluid to leak between the inner and middle ear

25
Q

what are the symptoms of perilymph fistulas

A

hearing loss, tinnitus, vertigo

26
Q

what is the duration and treatment for perilymph fistulas

A

can be lifelong, and treatment requires referral to ENT, need decongestants, surgery.

27
Q

do you have vertigo with unilateral or bilateral vestibular loss

A

unilateral

28
Q

what are some vestibular disorders, health conditions for central problems

A

brain stroke or cerebellar stroke, migraine, TBI, concussion, neurodegenerative

29
Q

where is the lesion with a central problem

A

in the vestibular nuclei, and in their connections to the brain

30
Q

what are the causes of central vestibular disorders

A

stoke, concussion, TBI, tumor, atrophy, MS, PD, Arnold chiari malformation

31
Q

if there is an infarct near the pons, what kind of results do you get

A

visual and vestibular deficits

32
Q

if there is a lesion in the cerebellum, what are the results

A

spinocerebellar tracts, vestibulocerebellar tracts and severe imbalance and dizziness

33
Q

if there is diffuse axonal injury what are we expecting

A

imbalance, double vision, many other symptoms

34
Q

what is a vestibular migraine

A

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

35
Q

what are the signs and symptoms of a vestibular migraine

A 
visual or auditory aura 
dizziness
nystagmus
nausea 
light and sound sensitivity
36
Q

what is the duration and treatment for vestibular migraines

A

duration is minutes to hours to days

treatment is PT and vestibular rehab and dietary changes, meds, behaviors and exercise

37
Q

what is cervicogenic dizziness (non-vestibular)

A

abnormal afferent signals from the neck that create various sensations of altered orientation in space and equilibrium. PT very effective

38
Q

what is anxiety related dizziness (mood or psychological and non-vestibular)

A

linkage between pain paths and vestibular paths and control of emotion and affect. lightheaded or woozy, and imbalanced. may need head doctor, meds, PT

39
Q

what are some other central problems to worry about (non-vestibular)

A

orthostatic hypotension
B12 deficiency
vertebral artery insufficiency
hypoglycemia

Clinical Neuroscience (20 decks)

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