Vertigo Flashcards
(29 cards)
What is vertigo?
The false sensation that the body or environment is moving/spinning
What are the causes of vertigo? How can these causes be classified anatomically?
Peripheral lesions (pathology affecting the inner ear):
- BPPV (most common)
- Meniere’s disease
- Vestibular neuronitis
- Labyrinthitis
- Acoustic neuroma
Central lesions (pathology affecting the brainstem or cerebellum):
- Multiple sclerosis
- Posterior circulation stroke
- Cerebellar/brainstem tumour
For each of the following causes of vertigo, is the vertigo typically episodic or continuous…
- BPPV
- Meniere’s disease
- Labyrinthitis
- Vestibular neuronitis
- Acoustic neuroma
- Episodic
- Episodic
- Continuous
- Continuous
- Continuous
How long do attacks of BPPV typically last?
A few seconds to a minute
How long do attacks of Meniere’s disease typically last?
20 minutes to several hours
Is the onset of labyrinthitis acute or gradual? How long does this condition typically last?
Acute onset, typically lasting a few weeks
Is the onset of vestibular neuronitis acute or gradual? How long does this condition typically last?
Acute onset, typically lasting a few weeks
Is the onset of acoustic neuroma typically acute or gradual?
Gradual (slow-growing tumour)
What does BPPV stand for?
Benign paroxysmal positional vertigo
Describe the pathophysiology of BPPV
Crystals of calcium carbonate (called otoconia) become displaced within the semi-circular canals, which disrupts the normal flow of endolymph
Typically, what can trigger an attack of BPPV?
Specific types of head movements, e.g. turning over in bed
BPPV is most common in which age group?
Older adults
Which manoeuvre is used to diagnose BPPV?
What does this manoeuvre trigger?
Dix-Hallpike manoeuvre (Dix for Dx - diagnosis)
This manoeuvre will trigger:
- Rotational nystagmus
- Symptoms of vertigo
Which manoeuvre is used to treat BPPV?
Epley manoeuvre
Describe the pathophysiology of Meniere’s disease
Excessive build up of endolymph in the inner ear
What is the typical triad of symptoms in Meniere’s disease?
- Vertigo
- Hearing loss
- Tinnitus
Describe the pharmacological management of Meniere’s disease
Acute attacks:
- Prochlorperazine
- Antihistamines, e.g. cyclizine, cinnarizine
Prophylaxis:
- Betahistine
Describe the pathophysiology of labyrinthitis
Inflammation of the inner ear
Labyrinthitis is typically preceded by…
A viral URTI
Describe the pathophysiology of vestibular neuronitis
Inflammation of the vestibular nerve
Vestibular neuronitis is typically preceded by…
A viral URTI
How can you distinguish between labyrinthitis and vestibular neuronitis?
How do you remember this?
Labyrinthitis is associated with hearing loss and tinnitus (whereas VN is not)
Labyrinthitis = Loss (of hearing)
Describe the pharmacological management of labyrinthitis and vestibular neuronitis
Both conditions are self-limiting and typically resolve within a few weeks.
Acute symptoms can be managed as follows for both conditions:
- Prochlorperazine
- Antihistamines, e.g. cyclizine, cinnarizine
What is an acoustic neuroma?
Benign tumour of the Schwann cells surrounding the vestibular nerve
