4 - ENT - Vertigo - Peripheral vertigo Flashcards Preview

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Flashcards in 4 - ENT - Vertigo - Peripheral vertigo Deck (18):
1

how to peripheral diff to central vertigo

peripheral affects the labyrinth or vestibular nerve

2

clinical features of peripheral vertigo

vertigo, horizontal nystagmus away from lesion, unless irritative
hearing loss, tinnnitus, and N+V are more common

3

6 possible causes for peripheral vertigo

menieres
benign paroxysmal positional vertigo BPPV
acute vestibular failure
vestibular neuronitis
drug induced vertigo
migraine associated

4

5 features of menieres

recurrent attacks of vertigo - 10mins-24h duration

tinnitus and fluctuating sensorineural loss

fullness of ears

N+V

may give permanent deafness

5

what must be ruled out if ?menieres

acoustic neuroma, otosyphillis

6

what is the cause of menieres

what Ix should be done

cause - unknown, possible excess fluid in endolymphatic fluid compartment

audiometry, electocochleography, CT/MRI

7

mgmt of menieres (medical)

spontaneous resolution common - 70%
bed rest, sedatives
anti-emetics - beta histine may be helpful
intratympanic gentamicin

8

mgmt of menieres surgical

endolymphatic sac decompression
vestibular nerve section
labyrinthectomy - gives deafness

9

BPPV - what? other Sx?

attacks of sudden rotational vertigo lasting >30sec provoked by head turning

no other oto/neuro Sx

10

Causes of BPPV

idiopathic
middle ear disease
trauma
post viral

11

Hallpike test - how? what does it do? what does it show?

turn head to affected side - provokes vertigo and horizontal nystagmus - fatigues after <1min

if no fatigue consider central cause

12

mgmt of BPPV + prognosis

positioning exercises for vestibular rehab

usually resolves over 12-18 months

13

Acute vestibular failure - causes

post viral
bact labyrinthitis (AOM/cholesteatoma)
cholesteatoma
vascular, trauma, autoimmune, idiopathic

14

acute vestibular failure - what happens? resolution?

sudden onset of SN deafness, vertigo, N+V, nystagmus

recovery usually within 2-3 weeks, although hearing loss may persist

15

mgmt of acute vestibular failure

plasma expanders, carbogen gas to improve blood supply to labyrinth

steroids

16

vestibular neuronitis - cause? what happens?

prob viral

sudden vertigo with N+V and nystagmus - no hearing loss

17

vestibular neuronitis - duration? mgmt?>

lasts a few days
mgmt - bed rest, vestibular sedatives/anti-emetics

18

drug induced vertigo - what drugs

aminoglycosides, metronidazole, diuretics, cytotoxics, sedatives, antidepressants

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