9 Vertigo Flashcards
(12 cards)
Benign Paroxysmal positional vertigo
55y, Sudden vertigo by moving head, 10-20 seconds, tinnitus, nausea
Benign Paroxysmal positional vertigo Treatmet?
treat epley maneuver 80% improvement ( home version: brandt Daroff exercise 5-10days )
*Betahistine has limited value
Benign Paroxysmal positional vertigo Diagnosis?
Hallpike positive, fatigable, horizontal nystagmus to the affected ear,
Meniere’s disease Triad
Paroxysmal Vertigo, N/V, Sensory neural Low frequency deafness,
Meniere’s features?
lasting for hours usually unilateral, tinnitus, sensation aural fullness, nystagmus, Positive Romberg test
Meniere’s course of progression?
Progressive dilation and pressure endolymph, resolves in 5-10 years but will leave hearing loss
Meniere’s treatment?
Treat: Prochlorperazine, cyclizine, thiazide, low salt diet, vestibular rehab
Prophylaxis: Betahistine
Vestibular neuritis
HSV, upper respiratory infection, vertigo N/V, horizontal nystagmus, no hearing loss/tinnitus unlike labyrinthitis, Dx posterior stroke: Hints ( if nystagmus happens with head movement, its vestibular neuritis) exam, treat with 50mg prednislon 5day+ prochlorperazine 3day, cyclizine, promethazine, cinnarizine, vestibular rehab
Labyrinthitis
recent viral infection, sudden vertigo, N/V, sometimes hearing, tinnitus, supportive
Acoustic neuroma (8)/vestibular schwannoma
benign, Cerebellopontine angle (cerebellar), unilateral tinnitus, sensorineural unilateral hearing loss, air conduction greater than bone, Weber lateralises to opposite side, often comes with loss corneal reflex (5), 7 can get involved too
Medullary neurofibroma: Hydrocephalus
Diagnosis: MRI
Raised ICP: 6th nerve palsy
Bilateral: Neurofibromatosis 2
Histology: Antoni A or B pattern, verocay bodies
Vertebrobasilar ischemia
Old, Triggered by neck extension
Glomus Jugulare tumor/paraganglioma
7,8,9,10,11,12, pulsatile reddish blue mass behind tympanic membrane
