vertigo Flashcards

1
Q

what is vertigo ?

A

a false sensation of rotation or spinning and movement of the surrounding environment

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2
Q

broadly, what are the types of vertigo ?

A

peripheral and central

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3
Q

what is the difference between central and peripheral vertigo ?

A

central vertigo is to do with a brain lesion
peripheral involves the ear and the mechanisms of balance in the ear

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4
Q

what are the causes of peripheral vertigo ?

A

benign paroxysmal positional vertigo
vestibular neeuritis
Menieres disease
Labrynthitis

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5
Q

what are the causes of central vertigo ?

A

vestibular migranes
acoustic neuroma
brainstem or cerebellar lesions

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6
Q

what is the other name for an acoustic neuroma ?

A

vestibular schwannoma

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7
Q

what is the aetiology of benign paroxysmal positional vertigo ?

A

free floating otoliths that continue movement even without any head movement

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8
Q

what is the presenting picture of BPPV ?

A

sudden onset
episodic
rotatory vertigo
lasts for seconds to a few minutes
NO HEARING LOSS

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9
Q

what test is used to diagnose BPPV ?

A

Dix-Hallpike test

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10
Q

what is the presentation of Vestibular neuritis ?

A

sudden onset
rotatory vertigo
severe
persistent for more than 24 hours
can’t get off bed for days
improves in several days to weeks
NO HEARING LOSS

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11
Q

what is the other term also used to describe Menieres disease ?

A

Endolymphatic hydrops

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12
Q

what is the presentation of meniere’s disease ?

A

gradual onset
rotatory vertigo that may last up to hours
nausea and vomiting
fluctuating sensorineural hearing loss with a low frequency threshold
tinnitus
aural fullness usually felt before onset of vertigo

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13
Q

what is labrynthitis ?

A

inner ear inflammationn

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14
Q

what is the presentation of labrynthitis like ?

A

gradual onset
vertigo
nausea and vomiting
nystagmus
SNHL or mixed

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15
Q

what is the presentation of a vestibular migrane ?

A

sudden rotatory severe vertigo can last minutes to hours
classically associated with:
headache/migrane
photophobia/visual disturbancees
Phonophobia
not always present

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16
Q

where do acoustic neuromas arise from ?

A

schwann cells of vestibular nerves
in the cerebellopontine angle

17
Q

what is the presentation of acoustic neuroma ?

A

unilateral or asymmetrical SNHL
very poor speech discrimination
normal otoscopy

18
Q

how is an acoustic neuroma diagnosed ?

A

MRI

19
Q

what is the presentation of central veertigo secondary to brainstem or cerebellar ischemia ?

A

usually lasts for 20 minutes to 24 hours and associated with other brainstem characteristics such as diplopia and autonomic disturbances

20
Q

what investigations aree required for cases of vertigo ?

A

full neurological examination
pure tone audiometry
Dix-hallpike test
Videonystagmography
MRI

21
Q

what is the treatment for BPPV ?

A

first localization through the DDix-Hallpike test then treat with Epley’s manoeuver

22
Q

what is the management for cases of BPPV that are resistant where Epley’s maneuver was ineffective ?

A

Brandt-Daroff exersices

23
Q

what is the treatment of vestibular neuritis ?

A

rest
antivertigo drugs
Antiemetics
Steroids
Benzodiazepams in acute stages

24
Q

what is the management for menieres disease ?

A

pressure reducing therapies :
low salt diets
Betahistines
diuretics

25
Q

what are betahistines ?

A

anti-vertigo drugs

26
Q

what is the best next step in management in cases of persistent Menieres disease ?

A

intratympanic injection of steroid and gentamicin

27
Q

what is the management of vestibular migranes ?

A

avoid triggers:
chocolate
nuts
dehydration
high salt diets
old cheese
anxiety
disturbed sleep pattern

28
Q

what are the migraine preventative medications ?

A

topiramate
rizatriptan ( selective serotonin receptor agonist)

29
Q

what medications can be taken during an attack of vestibular migraine ?

A

triptans
ergotamine

30
Q

what is the function of ergotamine ?

A

preventing blood vessel expansion

31
Q

what is the commonest cause of central vertigo ?

A

vestibular migranes

32
Q

what is the commonest cause of peripheral vertigo ?

A

benign paroxysmal positional vertigo