Equilibrium and Dizziness - Cohen Flashcards
dizzy
vertigo vs. light-headed?
dizziness
altered sense of orientation in space
light-headed
blood flow to brain low
MC cause - hypotension
also medications
no cause - psychogenic dizziness
vertigo
problem with vestibular system
-CN VIII
sense of room spinning
MC cause of vertigo
peripheral - semicircular canals
central - brainstem/cerbellar - stroke, hemorrhage, MS, tumor, alcohol, degenerative, migraine
benign paroxysmal positional vertigo
getting out of bed
- may cause N/V
- walking impaired
sometimes - recent cold or upper resp infection
full relief - being still
lasts 1-2 weeks - rarely more than 1 month
make sure they can walk
BPPV pathology
detachment of otolithic crystals in macule of utricle or saccule
floating in semicircular canals
move these debris - sensation of vertigo
diagnosis of BPPV
dix-hallpike maneuver
-quick head turn - sitting up and bring head down and to side
no hearing loss
tx of BPPV
epley maneuver
meds - meclizine**, scopolamine patch, promethazine, diazepam
menieres disease
recurrent attacks of vertigo, tinnitus, decline in hearing and sense of fullness or pressure in one ear
pt has hearing loss
terrible vertigo - less than hour - debilitating - immobilize patinet
endolymph expands - and bursts
hearing loss
with menieres disease - eventually
menieres tx
meclizine, promethazine, scopolamine
low salt diet - K sparing diuretic
surgical drainage
shunt for endolymph - hard to place
most patient - lose attack eventually w/out surgery
migraines
one of MC causes of intermittent vertigo - young adults and children
acoustic schwannoma
B9 tumor - or vestibular portion of CN VIII
pressure to deafness
hearing loss at first, then vertigo and HA
chronic sense of imbalance
roaring tinnitus - becomes constant - machine-like noises**
can then lose CN VII and V
tx of acoustic schwannoma
surgical disease
gamma knife - smaller tumors
