FN: Vertigo Flashcards Preview

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Flashcards in FN: Vertigo Deck (18):
1

Defintiion

the illusion of movement

2

Causes

Peripheral/Vestibular
Central

3

Peripheral/Vestibular

Menieres
BPV
Labyrinthitis

4

Central

Acousti neuroma
MS
Vertebrobasila insufficiency/stroke/ Head injury
Inner ear syphilis

5

Drugs (central/ototoxic)

Gentamicin
Loop diuretics
Metronidazole
Co-trimoxazole

6

History

Is it true vertigo or just light-headedness? - which way are things moving?
timespab
Associated symptoms: n/v, hearing loss, tinnitus. nystagmus

7

Examination and tests

Hearing
Cranial nerves
Cerebellum and gait
Rombergs +ve = vestibular or proprioception
Hallpike manouvre
Audiometry, calorimetry, LP, MRI

8

Menieres disease path

dilatation of endolymph spaces of membranous labyrinth (endolymphatic oedema)

9

Menieres disease presenation

Attacks occur in clusters and last up to 12 h
Pregressive SNHL
Vertigo and n/v
Tinnitus
Aural fullness

10

Menieres disease investigations

audiometry shows low-freq SNHL which fluctuates

11

Menieres disease Rx Medical and surgical

Medical: Vetrigo: cyclizine, betahistine

Surgical:
1. Gentamicin instillation via grommests
2. Saccus decompression

12

Vestibular Neuronitis/Viral Labyrinthitis presentation

Follows febrile illness (e.g. URTI)
Sudden vomiting
Severe vertigo exacerbated by head movement

13

Vestibular Neuronitis/Viral Labyrinthitis Rx

Cyclizine
Improvement in days

14

Bening Positional Vertigo: BPV pathology

displacement of otoliths in semicircular canals
Common after head injury

15

BPV presentation

sudden rotational vertigo for

16

BPV causes

idiopathic
Head injury
Otosclerosis
Post-viral

17

BPV dx

Hallpike manoeuvre - upbeat-torsional nystagmus

18

BPV rx

self-limiting
Epley manoeurve
Betahistine: histamine analogue

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