exam 2 - peri and central Flashcards

(41 cards)

1
Q

acute unilateral vestibular loss - sym

A
  • Sudden onset
  • May have hearing loss
  • Spontaneous nys – horizontal, alexander law
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2
Q

acute unilateral vestibular loss - test

A
  • Nys decreases with fixation
  • (+) HIT
  • (+) head shake test
  • (+) vibration induced nys
  • (+) DVA
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3
Q

Vestibular neuritis - what is it

A

a disorder that affects the vestibulocochlear nerve of your inner ear, inflammation

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4
Q

Vestibular neuritis - sym

A
  • Vertigo that can last for days
  • No hearing loss, fullness in the ear
  • May have flu like sym prior to onset of vertigo
  • Nystagmus - Spontaneous nys
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5
Q

Vestibular neuritis - test

A

none stated

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6
Q

Vestibular neuritis - medical treatment

A

Medical management: effective within the first month
- Methylprednisolone
- 10-day course of prednisone

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7
Q

Chronic unilateral vestibular loss - sym

A
  • Chronic Dizziness
  • Walking - Off balance, Blurring with head movements
  • May have hearing loss
  • Induced by head movements
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8
Q

Chronic unilateral vestibular loss - test

A
  • (maybe +) HIT
  • (+) DVA
  • May fall when standing on foam – EC
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9
Q

Subjective BPPV - def

A

Adults that have BPPV with no nys but the sensation of BPPV with dix hall pike

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10
Q

subjective BPPV intervention

A

Treat like they have a positive test – do not treat pt forever

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11
Q

Meniere’s disease - what is it

A

excessive buildup of endolymph causing a higher pressure than normal which can disrupts the sensory system

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12
Q

Meniere’s disease - sym

A
  • Ear pressure (fullness)
  • Low frequency hearing loss
  • Tinnitus
  • Spontaneous attacks – drop attacks
  • Vertigo attacks – 20 min - hours
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13
Q

Meniere’s disease - treatment

A

Endolymphatic surgery

Vestibular ablation
- Chemical
- Surgical

Medical management
Intratympanic steroids
Salt/caffeine restriction
Diuretic
Vasodilator
Immunotherapy

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14
Q

Meniere’s disease - test

A
  • Asymmetric hearing
  • Difficulty standing on foam
  • Possible autoimmune family history
  • Abnormal caloric
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15
Q

Superior canal dehiscence - what is it

A

sound or pressure induced vertigo of the superior SSC (rare)

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16
Q

Superior canal dehiscence - sym

A
  • Load sound cause object in the VF to move
  • Dizziness intros by coughing or sneezing
  • conductive hearing loss
  • Hear their heart, voice, maybe eye movement in the effected ear, foot steps hitting the ground, 262 Hz tunning fork on malleolus
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17
Q

Superior canal dehiscence - treatment

18
Q

Ramsey hunt syndrome - sym

A
  • Ipsilateral facial weakness
  • Ear pain

may have hearing loss

19
Q

Bilateral vestibular disease - def

A

hypofunction of the vestibular nerves or labyrinths on both sides

20
Q

Bilateral vestibular disease - sym

A
  • Oscillopsia
  • Ataxia – wide base of gait
  • Frequent falls
  • No vertigo – no spinning
21
Q

Bilateral vestibular disease - test

A
  • (+) Bilateral HIT
  • (+) DVA
  • Fall on posturography 5&6 – sometimes 4
  • Decrease caloric findings
22
Q

Bilateral vestibular disease - treatment

A

VOR – just to see if anything is left

Substitution exercises

23
Q

Psychiatric dizziness - three categories

A
  • panic disorders
  • agoraphobia
  • hyperventilation syndrome
24
Q

Psychiatric dizziness - symptoms

A
  • floating, spinning, swimming of the head
  • tension headaches
  • palpations
  • gastric disorders
  • sym constant
    o may increase with stress
25
what is Persistent postural perceptual dizziness (PPPD)
Functional movement disorder – someone can appear to have a spinal cord injury, they cannot stand or walk, but they can actually move all of their bones and muscles
26
Persistent postural perceptual dizziness (PPPD) - presentation
- These pt brains are built differently – the morphology of their grey matter is different - There is normally a vestibular trigger – BPPV, neuritis - These pt do not recover from their vestibular issues – long term problem o Maladaptive
27
MS - cause
demylienation of the axons
28
ms - sym
- Focal neuro signs - Recurrent attack of vertigo - Vertical nys – non fatiguing o See saw nys
29
MS - age group
20-40
30
Vestibular migraine - occcurance
most common vestibular issue
31
Vestibular migraine - sym
- Pain in the head and neck - Visual changes – photophobia, blurring - Mood changes - May be autosomal dominant – trait seen in families - Sometime positional nys – persistent
32
what is a Chiari malformations
cere goes through the foramen magnum
33
Chiari malformations
- Headache - Neck pain - Down beating nys with IR goggles - Balance problems - Dysphagia - Weakness - Vertigo
34
Perilymphatic fistula (rare) - sym
- Vertigo induced by – coughing, sneezing, Valsalva - Fluctuating dizziness - May have hearing loss
35
Perilymphatic fistula (rare) - cuases
- Barotrauma - Head injury - Heavy lifting
36
Perilymphatic fistula (rare) - tests
- (+) tragal pressure - (+) Valsalva test - (+) occasional tullios phenomenon
37
Perilymphatic fistula (rare) - treatment
refer out
38
Orthostatic tremor - presentation
- Tremor o Tremor that cannot be seen o Position specific – standing o Disappears or decreases – walking, sitting, supine - CC: I cannot stand for longer than a few minutes - Fear of falling
39
Orthostatic tremor - medical management
- Gabapentin - Primidone - Pregabalin
40
Central vestibular - sym
- Inability to walk – gait ataxia - Dizziness/vertigo - Head tilt to the side
41
Central vestibular - tests
- (-) HIT - Focal neuro signs - Changing direction of nys - Sig imbalance