ENT - Vertigo

Question 1

what are the 2 types of vertigo?

Answer 1

• central: brain stem, cerebellum

- peripheral: labyrinth, vestibular

Question 2

where are the end organ receptors in the vestibular apparatus?

Answer 2

cupula

Question 3

the utricle contains _______________ (fluid)

Answer 3

endolymph

Question 4

where are the otoliths located?

Answer 4

utricle

Question 5

what is labyrinthitis / vestibular neuronitis?

Answer 5

acute unilateral loss of peripheral vestibular function

Question 6

labyrinthitis / vestibular neuronitis is associated with ________ (3 things)

Answer 6

• vertigo
• N/V
• nystagmus

PERSISTENT (lasts for weeks)

Question 7

when is labyrinthitis / vestibular neuronitis typically seen?

Answer 7

post URI

Question 8

how can peripheral vertigos be suppressed?

Answer 8

visual fixation

Question 9

• sudden vertigo often overnight (noted on awakening)

- fixed horizontal nystagmus with fast phase toward healthy ear

Answer 9

vestibular neuronitis

Question 10

what is the classic triad of menieres disease?

Answer 10

• vertigo
• tinnitus (aggressively worsening)
• hearing loss (sensorineural)

Question 11

what is the pathogenesis of menieres disease?

Answer 11

build up of endolymphatic pressure in labyrinth (hydrops)

Question 12

what is the treatment for menieres disease?

Answer 12

vestibular suppressants

Question 13

what is a perilymphatic fistula? when do they occur?

Answer 13

• traumatic fistula at round or oval window

- after forceful cough, sneeze, scuba diving, direct blow

Question 14

what are the causes of central vertigo?

Answer 14

• infarcts
• CP angle tumors
• MS
• migraine

Question 15

what are the symptoms of lateral medullary syndrome?

Answer 15

• vertigo, nystagmus (VERTICAL)
• gait limb ataxia
• dysphagia, decreased gag
• ipsilateral facial hemianesthesia
• ispilateral horners
• contralateral arm trunk leg pain

Question 16

what is the cause of lateral medullary syndrome?

Answer 16

PICA infarct

Question 17

perilymphatic fistula is almost always associated with what type of history?

Answer 17

trauma

Question 18

what is the best drug class for vertigo?

Answer 18

benzos