Flashcards in Dizziness Deck (34)
The sense of imbalance, usually while walking
the sensation of moving/spinning
sensation of near fainting or lightheadedness
This is a special test that keeps patients from focusing their vision. It is used to help elicit certain types of nystagmas
MS and migraine with vertigo are types of _______ vertigo
Name 3 types of peripheral vertigo:
2) Menieres dz
3) vestibular neuritis
4) Ototoxic meds
5) Acoustic neuroma
Do you expect a patient with peripheral vertigo to have other neurological s/s (like dysarthria, vision change, etc)?
No, peripheral lesion is outside the CNS.
What direction is nystagmus in peripheral vertigo, if present?
HORIZONTAL and Unidirectional, toward normal ear
If you see nystagmus going in a purely vertical or torsional pattern, what can you say with high confidence?
Central source of vertigo
Patients with _______ vertigo can suppress nystagmus if they are allowed to focus on an object.
Patients with nystagmus that persists even after vertigo resolves have likely experienced __________ vertigo.
During an acute vertigo episode, patients with ________ vertigo can still walk with only minor instability
Deafness or tinnitus is ONLY present during an episode of _______ vertigo
benign positional vertigo is commonly attributed to ________ in the posterior semicircular canal
How long do episodes of BVP last?
< 1 min/episode, intermittent episodes x months
The ________ maneuver can be done in the office to reposition the calcium debris
The ________ maneuver can be done in the office to reproduce and therefore diagnose BPV.
What medication provides the best relief of BPV?
Your patient reports having had 2 spontaneous episodes of vertigo that lasted about 25 minutes each. During each episode, she reports a full feeling in her ears and heard ringing. What are you thinking?
What causes Meniere's?
"endolymphatic hydrops" aka fluid buildup in the labyrinth system...most common onset in 20-40's.
Rapid onset of vertigo with n/v and gait instability following a virus....
How will you tx vestibular neuritis?
How will you tx Meniere's?
A 50 year old male pt who works in a loud construction site comes in c/o tinnitus in one ear, he has vertigo and numbness in his face. After you r/o stroke, what is the next most likely cause?
Construction man from before wants to know how serious this is, and what you are going to do about it...
Typically benign, tx only if symptoms are intolerable. Then the options include radiation or surgery
Name a few ototoxic meds:
Pretty much anything that ends in "mycin"
Marcus Gunn Pupil. That is all you know....what should you be thinking?
How do you tx acute MS exacerbation?
IV steroids, methotrexate
Vertigo a/w Posterior circulation problems....highest risk is with pt's who have stroke risk.