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Otolaryngology > Dizziness > Flashcards

Flashcards in Dizziness Deck (28):
1

What are 5 complaints associated with dizziness?

1. Disequilibrium
2. syncope
3. lightheaded
4. ataxia
5. vertigo

2

Disease processes that cause true vertigo (illusion of motion) are mainly assoc with what?

Balance organs of the inner ear (peripheral vestibular disorders)

3

Central or peripheral vertigo?
BPPV, cholesteatoma, Ramsay Hunt Syndrome, Meniere's disease, otosclerosis?

Peripheral

4

Central or peripheral vertigo?
Cerebellopontine angle tumor, TIA, migraine, multiple sclerosis,

Central

5

Differentiate central vs peripheral vertigo.

Etiology for central relates to CNS; PNS for peripheral. central impairs gait and posture more bc involves balance and posture pathway.

6

If pt doesnt have true vertigo, what should you evaluate for?

Syncope or episodic hypotension
Neoplasm, demyelinating disease or vascular abnormality

7

What are 4 parts of the electronystagmography test to evaluate vestibular (balance) part of the inner ear?

1. Calibration test
2. Tracking test
3. positional test
4. caloric test

8

Which part of the ENG test measures responses to warm and cold water introduced to the ear canal.

Caloric test

9

What is the gold standard to test unilateral peripheral vestibular disorders?

ENG (electronystagmography)

10

Which part of the ENG test measures response due to head mvt?

Positional test

11

Which part of the ENG test evaluates ability for eyes to track a moving target?

Tracking test

12

Which part of the ENG test measures rapid eye movements?

Calibration test

13

What is the gold standard to diagnose bilateral vestibular weakness

Rotatory chair testing - pt spun slowly in a chair and test dizziness w/optokinetic testing and fixation test

14

What test is most useful in quantifying balance improvement after tx for a particular problem and can help ID functional dizzy pt. But shouldnt be used alone to dx vestibular disorders

Moving platform posturography

15

What is a useful test to evaluate Meniere's dz but doesnt really test the vestibular system?

electrocochleography - variant of brainstem audio-evoked response. Best performed during Meniere's attack

16

most common causes of vertigo seen by otolaryngologists

Benign paroxysmal positional vertigo (BPPV)

17

BPPV is caused by sediment, such as ___ (calcium carbonate crystals) that have become free floating within the ___ ear.

1. otoconia
2. inner

18

What is the balance canal fluid in the inner ear that stimulates the vestibular division of the 8th CN?

Endolymph

19

What type of vertigo lasts 24-48hrs and gets less intense over this time with hearing unchanged?

Vestibular neuronitis - nausea common

20

What type of vertigo lasts 30min-4hrs?

Meniere's disease

21

What type of vertigo lasts less than 1 min?

BPPV

22

BPPV is commonly seen after what events?

Significant head trauma or episode of vestibular neuronitis

23

Tx for BPPV?

1. Canolith reposition maneuver (Epley or Semont) - 80% effective
2. Meds INEFFECTIVE
3. Bradnt-Daroff exercises at home
4. Severe cases: Transtympanic gentamycin injections, posterior semicircular canal plugging, vestibular nerve sectioning, sacculotomy, and labyrinthectomy

24

What is another name for vestibular neuronitis? Cause?

Labyrinthisis
inflammation, secondary to a viral infection, of the vestibular portion of the 8th CN or of the inner ear balance organs (vestibular labyrinth). Freq assoc w/URI

25

How do you tx vestibular neuronitis?

Symptomatically
1. vestibular supressant meds
2. antiemetics
3. tapering oral steroids
4. Vestibular rehab if persist for mo to yrs

26

What is this condition?
Patients develop intense, episodic vertigo, usually lasting 30 min - 4 hrs, and assoc w/fluctuating hearing loss, roaring tinnitus, and the sensation of aural fullness. Even after the episode is over, some hearing loss often remains

Meniere's dz

27

Possible cause of Meniere's dz?

Symptoms are believed to be secondary to a distention of the endolymphatic space within the balance organs of the inner ear.

28

What are tx strategies to dec endolymphatic fluid pressure w/in the vestibular portion of the inner ear for Meniere's dz (6)?

1. salt restriction
2. thiazide diuretics
3. vestibular ablation by instillation of ototoxic meds (gentamicin)
4. endolymphatic sac decompression into mastoid cavity
5. vestibular nerve section
6. labryinthectomy - destroys hearing