Vertigo

Question 1

Central v.s. Peripheral vertigo

Answer 1

Peripheral
- Unidirectional.
- Never reverses direction.
- Horizontal with a torsional component
- Nil other neurological signs
- May have tinnitus or deafness

Central
- Can reverse direction
- Can be any direction
- Other neurological signs often present
- Severe postural instability
- Nil deafness or tinnitus.

Question 2

Vestibular Neuronitis vs Labyrinthitis

Answer 2

Vestibular Neuronitis - Acute vertigo + nausea + Vomiting
Labyrinthitis - Acute vertigo + nausea + Vomiting + Hearing loss +/- Tinnitus

Question 3

Clinical features of common causes of vertigo

Answer 3

BPPV - Lasts seconds. Precipitated by predictable head movements. Peripheral nystagmus
Menieres - Minutes to hours. Spontaneous. Can be associated with aural fullness. Peripheral nystagmus. Audiometry shows low-frequeny sensorineural hearing loss.
Vestibular Neuritis - Days. Acute onset. Peripheral nystagmus. Head thrust usually abnormal.
Cerebellar infarction - Acute onset. .Central nystagmus. Postural ataxia.