Best differential when the patient says: “I might fall.”
a. syncope
b. disequilibrium
c. true vertigo
d. just a difficult patient
b. disequilibrium
A neurologic kind of dizziness.
Best differential when the patient says: “The room is spinning.”
a. syncope
b. disequilibrium
c. true vertigo
d. just a difficult patient
c. true vertigo
A vestibular problem.
Best differential when the patient says: “I’m giddy.”
a. syncope
b. disequilibrium
c. true vertigo
d. just a difficult patient
a. syncope.
“I might faint.”
“I’m light-headed.”
This is more of a cardiogenic problem.
Ensures that the visual image that falls on the retina remains focused, regardless of head position.
Vestibulo-ocular reflex
Turning the head to the RIGHT, activates which horizontal semicircular canal.
RIGHT.
The RIGHT vestibular nucleus activates the LEFT or RIGHT abducens nucleus?
LEFT.
R vestibular nucleus -> L abducens nuclues -> lateral rectus of L eye -> medial longitudinal fasciculus -> R oculomotor nerve -> medial rectus of the R eye -> both eyes look to the L (when head is moved to the R)
Controls the accuracy of returning eyes to the midline position.
Cerebellum
Turning your head to the right while your head is bent forward activates which semicircular canal?
Right Superior
The slow component of eye motion when we move our heads.
The drifting of the eyes as a result of the stimulation of the contralateral CN VI.
PERIPHERAL or CENTRAL Vertigo?
Associated with ear problem.
PERIPHERAL.
PERIPHERAL or CENTRAL Vertigo?
Sudden onset
PERIPHERAL
PERIPHERAL or CENTRAL Vertigo?
Frequent neurologic symptoms
CENTRAL
PERIPHERAL or CENTRAL Vertigo?
Spinning or rotating quality.
PERIPHERAL
High dipolar lenses that prevent fixation, allowing vestibular nystagmus to be seen clearly and to separate him from the environment.
Franzel Lenses
Eyes overshooting towards the Right during a Rapid Impulse Test means that the lesion is on which side?
Right.
These are diagnostic maneuvers for Benign Paroxysmal Positioning Vertigo, EXCEPT:
a. Dix-Hallpike Maneuver
b. Caloric Maneuver
c. Rapid Impulse Test
d. NOTA
c. Rapid Impulse Test
- it is a test for ocular instability and labyrinthine function
The indicator for a positive Dix-Hallpike Maneuver is:
a. (+) falling
b. (+) nystagmus
c. (+) overshooting of eyes
d. (+) dizziness
b. (+) nystagmus.
The Dix-Hallpike Manuever is a test for Benign Paroxysmal Positioning Vertigo where a patient is brought up rapidly from a lying position with the head rotated 45 degrees to the left or to the right.
During caloric testing, cold water irrigation of the R ear results in nystagmus towards which ear?
L ear
For nystagmus:
COWS: Cold Opposite, Warm Same.
Cold water = FAST phase of nystagmus to the side Opposite from the cold water filled ear
Warm water = FAST phase of nystagmus to the Same side as the warm water filled ear
Used in NASA to prepare astronauts for zero gravity environments; also for anti-vertigo treatment
Barany Chair
A patient rotated to the Left during an Unterberger test. The lesion is in the:
Left
Most common kind of vertigo in clinical practice.
Benign Paroxysmal Positioning Vertigo
A maneuver which can be used to treat Benign Paroxysmal Positioning Vertigo.
Vestibular Rehabilitation Exercises such as:
Semont Maneuver
Canalith Repositioning Maneuvers.
*
Vertigo precipitated or exacerbated by stressors, which can be typical situations.
Phobic Postural Vertigo (aka non-otogenic dizziness and psychogenic dizziness)
- occurs usually in obsessive-compulsive or reactive-depressive types.
A disease caused by impaired drainage of endolymph due to lymphatic channel dilation leading to accumulation of endolymph inside the SCC.
Meniere’s Disease
The triad of inner ear pathology:
1) dizziness
2) tinnitus
3) hearing loss
The 5Ds of Cerebrovascular Disease:
1) Dizziness
2) Diplopia
3) Dystaxia
4) Dysphagia
5) Dysarthria
