Vertigo

Question 1

Persistent Postural-Perceptual Dizziness: Type

Answer 1

Rocking/swaying disequilibrium

Results in rocking/swaying/feeling of unsteadiness when standing still

Question 2

Persistent Postural-Perceptual Dizziness: Tempo

Answer 2

Persistent, episodic, spontaneous or triggered

Question 3

Persistent Postural-Perceptual Dizziness: Time/Duration of vertigo

Answer 3

Comes and goes - experience symptoms for atleast 3 months

Question 4

Persistent Postural-Perceptual Dizziness: Triggers/aggravating factors

Answer 4

Rapid movement
Visually stimulating environment
Stress
Lack of sleep

**NOTE: Anxiety related

Question 5

Persistent Postural-Perceptual Dizziness: Nystagmus

Answer 5

Positional and post-head shaking

Question 6

Persistent Postural-Perceptual Dizziness: Nausea

Answer 6

Usual

Question 7

Persistent Postural-Perceptual Dizziness: Postural instability - Ataxia/unsteadiness

Answer 7

With head movement, visual motion

Question 8

Persistent Postural-Perceptual Dizziness: Mechanism

Answer 8

Uncompensated vestibular loss
Anxiety

NOTE:
- After a vestibular insult (like vestibular neuritis or BPPV), the brain is supposed to recalibrate balance using visual, proprioceptive, and vestibular input.

• In PPPD, this recalibration is incomplete or maladaptive.
• The brain starts relying too much on visual and proprioceptive cues, making the person hyper-aware of motion, posture, and surroundings.
• This causes persistent dizziness

Question 9

Persistent Postural-Perceptual Dizziness: Specific symptoms

Answer 9

Constant dizziness
Agg by head motion or visually stimulating environment

Question 10

Persistent Postural-Perceptual Dizziness: Special Tests

Answer 10

VFTS (Vestibular function tests)
Balance
Gait measures

Question 11

Persistent Postural-Perceptual Dizziness: Treatment options

Answer 11

VRT
CBT/psychoeducation
Medicaton

Question 12

Acute Vestibular syndrome (Vestibular Neuritis): Type

Answer 12

Rotational vertigo

Question 13

Acute Vestibular syndrome (Vestibular Neuritis): Tempo (episodic vs spontaneous)

Answer 13

Spontaneous & continous.

Question 14

Acute Vestibular syndrome (Vestibular Neuritis): Time

Answer 14

24-72hrs

Question 15

Acute Vestibular syndrome (Vestibular Neuritis): Triggers/aggravating factors

Answer 15

Possibly following URTI
GI infection
Virus

Question 16

Acute Vestibular syndrome (Vestibular Neuritis): Nystagmus/Beat?

Answer 16

Yes
Direction fixed
Beats away from side of lesion

Question 17

Acute Vestibular syndrome (Vestibular Neuritis): Nausea

Answer 17

Moderate

Question 18

Acute Vestibular syndrome (Vestibular Neuritis): Postural instability

Answer 18

Yes but usually able to walk using wall/furniture

Question 19

Acute Vestibular syndrome (Vestibular Neuritis): Postural instability

Answer 19

Yes but usually able to walk using wall/furniture

Question 20

Acute Vestibular syndrome (Vestibular Neuritis): Mechanism

Answer 20

Asymmetry of vestibular inputs due to impairment of vestibular nerve

Question 21

Acute Vestibular syndrome (Vestibular Neuritis): Specific symptoms

Answer 21

Acute spontaneous onset
VN: no hearing loss (Labyrinthitis: hearing loss)

Question 22

Acute Vestibular syndrome (Vestibular Neuritis): Special Tests

Answer 22

Vestibular function test
HINTS+ normal

Question 23

Acute Vestibular syndrome (Vestibular Neuritis): Treatment Options

Answer 23

Avoid prolonged vestibular suppressants
VRT 12-20 min per day