Dizziness Flashcards

1
Q

what is dizziness?

A

a non specific term for a feeling of imbalance

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2
Q

what is vertigo?

A

a sensation of movement, usually spinning

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3
Q

what does vertigo lasting seconds suggest?

A

BPPV

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4
Q

what does vertigo lasting hours suggest?

A

meniere’s

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5
Q

what does vertigo lasting days suggest?

A

vestibular neuritis

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6
Q

what does vertigo lasting variable lengths suggest?

A

migraine associated vertigo

aka vestibular migraine

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7
Q

what symptoms, besides vertigo, are often associated with meniere’s disease?

A

hearing loss
tinnitus
aural pressure

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8
Q

what cause of vertigo should be considered if the patient gets dizzy rolling over in bed?

A

BPPV

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9
Q

what cause of vertigo should be considered if the first attack was severe and lasted hours with N+V?

A

vestibular neuritis

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10
Q

what cause of vertigo should be considered if the patient gets light sensitive during dizzy spells?

A

vestibular migraine

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11
Q

what cause of vertigo should be considered if one ear feels full or there is a hearing change when the vertigo comes on?

A

meniere’s disease

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12
Q

what are the five vestibular end organs?

A

ampullae of the semi circular canals (x3)

maculae of the utricle and saccule

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13
Q

what do the semi circular canals sense?

A

rotation

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14
Q

what do the utricle and saccule sense?

A

linear motion (horizontal and vertical)

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15
Q

what test can be done to test the function of the VOR?

A

the head impulse test

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16
Q

what does BPPV stand for?

A

benign positional paroxysmal vertigo

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17
Q

what is the most common cause of vertigo in adults?

18
Q

what are three possible causes of BPPV?

A

head trauma
ear surgery
idiopathic

19
Q

what is the pathophysiology behind BPPV?

A

otoconia from the utricle displaced into semi-circular canals

20
Q

what semi circular canal is often involved in BPPV?

A

most often the posterior one

21
Q

what are five common triggers of vertigo in BPPV?

A
looking up 
lying down 
bending forward 
moving head quickly 
rolling over in bed
22
Q

what is the diagnostic test for BPPV?

A

dix hallpike test

23
Q

how is BPPV managed?

A

repositioning manoeuvres

24
Q

name three repositioning manoeuvres that can be done for BPPV

A

epley
semont
brandt daroff

25
what is another name for vestibular neuritis?
labyrinthitis
26
what symptoms are associated with vestibular neuritis?
tinnitus hearing loss may have viral symptoms
27
what is the most likely cause of vestibular neuritis?
a virus
28
how is vestibular neuritis managed?
supportive - vestibular sedatives and anti-nausea medications
29
what is the cause of meniere's disease?
unknown
30
what is the pathophysiology behind meniere's disease?
endolymphatic hydrops
31
what is endolymphatic hydrops?
high pressure in the endolymph system of the inner ear
32
how is meniere's disease diagnosed?
a diagnosis of exclusion
33
how is meniere's disease managed?
supportive during episodes treat tinnitus hearing aids
34
how can episodes of meniere's disease be prevented?
salt restriction minimise caffeine and alcohol intake manage stress
35
what is the most common auditory symptom in vestibular migraine?
phonophobia
36
what is the treatment for vestibular migraine based on?
lifestyle modifications | trigger factors
37
what pharmacological treatments can be used for vestibular migraine?
abortive agents | prophylaxis
38
what are the abortive agents for vestibular migraine?
triptans
39
what drugs can be used as prophylaxis for vestibular migraine?
propranolol | amitriptyline
40
what is vestibular schwannoma?
a benign tumour of the CN VIII nerve sheath
41
how does vestibular schwannoma present?
progressive imbalance hearing loss tinnitus
42
how is vestibular schwannoma diagnsoed?
MRI