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Flashcards in Dizziness, Cohen Deck (43):
1

Definition of dizziness

altered sense of orientation in space

2

descriptions of dizziness

spinning
off balance
light headed
feathery
woozy
can't walk
sick
merry-go-round
high
cheap drunk

3

common causes light headedness

CV: Hypotension, intermittent drops in BP from antiHTN meds
arrhythmias, dec CO, valvular disease
autonomic: orthostatic hypotension
polyneuropathy or spinal disorders

4

psychogenic dizziness

no known cause dizziness
panic disorder

5

Vertigo

more than spinning
misperception of his orientation to the environment
some sense of spinning

6

Common causes vertigo

- peripheral
- central

7

peripheral vertigo

semicircular canals and utricle, saccule
benign parozysmal positional vertigo, vestibular neuritis, menieres disease, trauma

8

central vertigo

brainstem or cerebellar
strok hemorrhage
MS tumors alcohol degenerative disorders migraine

9

What is positional vertigo

benign paroxysmal positional vertigo

10

positional vertigo

intermittent vertigo lasting less than a minute assoc with changes in head position, looking up or down

11

positional vertigo cc

when getting up out of bed in the AM
nausea and vomiting too

12

Sx positional vertigo

cant walk well
recent cold or upper resp infection
get relief by being completely still
lasts 1-2 weeks

13

path behind benign paroxysmal positional vertigo

detachment of otolithic crystals of maculae of the utricle or saccule detach and gloat to post semicircular canal

14

is there loss of hearing with positional vertigo

no
sometimes have nystagmus

15

what can cause vertigo in someone with benign paroxysmal positional vertigo

quick head turn
Dix-Hallpike maneuver

16

non-Rx Tx of BPPV

epley maneuver, but cna also worsen it

17

Medications for tx BPPV

meclinzine
scopolamine patch
promethazine
dizepam

18

Menieres disease

recurrent attacks for years of vertigo, tinnitus and decline in hearing and a sense of fullness or P in one ear
hearing loss!

19

length of menieres disease

minutes or hours long separated by weeks or mo with no vertigo at all between attacks

20

cochlear variant menieres disease

prominent hearing loss without vertigo

21

Path menieres disease

increased volumne endolymph fluid-- buldging throughout inner ear

22

endolymphatic hydrops

menieres

23

what can happen during attack in menieres

rupture of membranes
spill K rich liquid into perilymph
damaging both vestibular nerve and cochlear hair cells

24

is menieres genetic

no
sporadic

25

during attack in menieres what is Tx

meclizine, promethazine or scopolamine patches

26

prophylaxis of menieres

low salt diet and K sparing diuretic

27

prognosis menieres

majority of patients seem to lose their attacks without surgery

28

central causes of dizziness

vertigo arising from the brain
including cerebellum, due to stroke, hemorrhage tumors

29

degenerative diseases causing central dizziness

alzheimers
parkinsons
CJD

30

one of most common cause of intermittent vertigo in young adults and children

migraine

31

acoustic schwannoma

benign tumor of vestibular portion of VIII CN
"vestibular neuroma"

32

complaints of acoustic schwannoma

hearing loss at first
later vertigo or HA and P in one ear
chronic sense imbalance
roaring tinnitus!!

33

acoustic schwannoma originates where

close to brainstem in internal auditory canal may compress VII and V CN

34

acoustic schwannomas grow where

cerebello pontine angle

35

Tx acoustic schwannoma

surgery for almost all patients
gamm knife radiation used for smaller tumors
meningiomas or malignant tumors in region

36

b/l acoustic schwannoma

NF II

37

primary functions cerebellum

coordination of movements
regulation of muscular tone
maintenance of posture and equilibrium

38

Primary cerebellar Sx

ataxia: lack of coordination
intention tremor

39

stroke causing vertigo

vertebral basilar system
brainstem strokes
cerebellar strokes

40

dangerous about cerebellar stroks

not on CT for 24 hours so may be sent home with fatal condition

41

HA diplopia
vertigo
difficulty walking

cerebellar stroke

42

72 hours after cerebellar stroke

size of infarct increase and if 4th ventricle closed patients may have hydrocephalus and fatal brainstem herniation

43

Tx cerebellar stroke

removal of one cerebellar hemisphere
emergency ventriculo-peritoneal shunt