MSRA: Vertigo

Question 1

What are the key features of Ménière’s disease?

Answer 1

Recurrent episodes/attacks of vertigo, tinnitus, and hearing loss
Sensation of aural fullness or pressure
Lasting minutes to hours
Fluctuating SNHL which overtime becomes permanent

Question 2

What is the management of Ménière’s disease?

Answer 2

Acute: buccal or IM prochlorperazine
Prevention: betahistine
Refer to ENT to confirm the diagnosis

Question 3

What is the presentation of vestibular neuritis?

Answer 3

Vertigo associated with nausea and vomiting lasting several hours to days secondary to inflammation of the vestibular nerve
No change in hearing
Often preceding viral illness
Management with prochlorperazine

Question 4

What are the features of BPPV?

Answer 4

Triggered by change in head position
Short lived episodes 10-20 seconds
Vertigo

Question 5

What is the diagnostic test for BPPV?

Answer 5

Dix-Hallpike manoeuvre

Question 6

What is the treatment of BPPV?

Answer 6

Epley manoeuvre