Causes of dizziness

Question 1

What is the difference between vertigo and dizziness?

Answer 1

Vertigo is a type of dizzy which is related to spinning

Question 2

What motion is the lateral semicircular canal responsible for?

Answer 2

Left to right movement

Question 3

What motion is the posterior semicircular canal responsible for?

Answer 3

Moving head to shoulder

Question 4

What motion is the superior semicircular canal responsible for?

Answer 4

Nodding

Question 5

What is the basics of the vestibularoccular reflex?

Answer 5

Means to focus on a point even when head not directly looking at it

Question 6

In what way can the eye affect balance?

Answer 6

Cataracts

Diabetes Mellitus

Question 7

How can joints affect balance?

Answer 7

Arthritis may make it mechanically difficult to stand

Question 8

What neurological impairments affect the balance system?

Answer 8

Migraines
MS
Space occupying lesions

Question 9

Where exactly in the SCC is the vestibulooccular reflex set up?

Answer 9

The cupula in the crista ampullaris

Question 10

What is the mechanism for the vestibule-ocular reflex?

Answer 10

Calcium carbonate crystals on the cupula activate hair cells to make APs when the endolymph causes the crystals to move

Question 11

If the vestibulo-ocular reflex isn’t working, what might occur?

Answer 11

Nystagmus

Question 12

In what direction does the nystagmus move?

Answer 12

Away from the affected ear.

E.g. if right ear then will point towards nose

Question 13

Why might anxiety lead to dizziness?

Answer 13

Hyperventilation

Question 14

What would you do on examination if dizzy was PC?

Answer 14

Otoscopy
Neurological exam
BP
Audiometry

Question 15

What is BPPV?

Answer 15

Benign positional paroxysmal vertigo

Question 16

What is the pathophysiology of BPPV?

Answer 16

Otoconia are displaced into the SCC causing the hair cells in the SCC to become depolarised unnecessarily

Question 17

What is the difference between BPPV and vertebrobasilar insufficiency?

Answer 17

VBI needs other symptoms e.g. visual disturbance, weakness or numbness

Question 18

When are vertigo symptoms often seen?

Answer 18

Looking up
Turning in bed
Getting out of bed in morning
Rising from bending

Question 19

True or False

There is tinnitus associated with BPPV

Answer 19

False

Question 20

What is Hallpike’s test?

Answer 20

Lie on couch so head is off the back and turn head away from affected side and to 45degrees

Question 21

What is Hallpike’s test for?

Answer 21

Nystagmus

Question 22

What is important to note about repeating Hallpike’s test?

Answer 22

Doesn’t give as accurate results the second time around

Question 23

What manoeuvre can be done to treat BPPV?

Answer 23

Epley manouevre

Question 24

What is the Epley manoeuvre?

Answer 24

Manual exercise involving turning the patient to move the otoconia from the SCC to the utricle

Question 25

What is vestibular neronitis?

Answer 25

Inflammation of vestibular nerve

Question 26

What symptoms does vestibular neuronitis present with?

Answer 26

Prolonged vertigo | NO tinnitus/hearing loss

Question 27

What causes labyrynthitis?

Answer 27

Virus

Question 28

What is different about labyrinthitis in terms of presentation as compared with vestibular neuronitis?

Answer 28

Labyrinthitis is associated with tinnitus or hearing loss

Question 29

What is the pathophysiology of Meniere's disease?

Answer 29

Too much endolymph

Question 30

What is a classic history of Meniere's disease?

Answer 30

Periodic vertigo with pro-drome Hearing loss Tinnitus Aural pressure

Question 31

What kind of hearing loss is present in Meniere's disease?

Answer 31

Sensory-neural

Question 32

What is conductive hearing loss?

Answer 32

Gap between bone conduction and that in air

Question 33

What is an example of conductive hearing loss?

Answer 33

OME

Question 34

Where is the problem is sensorineural hearing loss?

Answer 34

Cochlea

Question 35

What is the management for Meniere's disease?

Answer 35

Tinnitus therapy Hearing Aids Tx during episodes

Question 36

What symptomatic management is available for Menieres disease?

Answer 36

Betahistine | Anti-emetics

Question 37

Why is a low salt diet and diuretics prescribed for Meniere's disease?

Answer 37

To reduce levels of fluid (endolymph)

Question 38

What role does gentamicin play in Meniere's disease?

Answer 38

Destroys OHC so no sensation of falling