Vestibular Disorders Flashcards
(31 cards)
This a sensation of motion without movement or exaggerated motion with movement.
Vertigo
This is often described as a vague dizziness and presyncope
Light headedness
If you suspect vertigo, what questions should you obtain in the history?
- Quality of the vertigo
- Frequency/Duration
- Associated Sx
- Exacerbating Sx
- Medications, Illicit drugs, alcohol
What distinct physical exam finding would you see in a patient with vertigo?
What additional physical exam findings could you see?
Nystagmus
Romberg (Imbalance)
Pronator Drift
Poor Finger-to-nose
Distinguish between peripheral vertigo and central vertigo through evaluation of nystagmus
Peripheral vertigo….
Latent Horizontal/torsional nystagmus that does not change direction with gaze, displays response fatigue and is supressed with fixation. LESS Imbalance
Central Vertigo….
Non-latent vertical/horizontal/torsional nystagmus that changes with direction but does not respond to fatigue or fixation. MORE imblance
What are the FOUR most common causes of vertigo?
BPPV
Vestibular neuronitis/labyrinthitis
Vestibular migraine
Meniere’s Syndrome
This form of vertigo presents typically in short duration intervals, head positions exacerbate the Sx, and w/o hearing change/tinnitus.
BPPV
What maneuver can you preform to confirm BPPV?
Dix Hallpike Maneuver
What are FOUR different etiologies of BPPV?
- Trauma
- Prolonged Head Position
- Labyrinthitis
Meniere’s Disease
What maneuver is often used to treat BPPV?
What else can be used to treat BPPV?
Epleys Maneuver
Vestibular suppressants
If a patient presented with the complaint of vertigo lasting for a few hours to days, +/- hearing loss/tinnitus, and no specific trigger to the vertigo.
Vestibular Neuronitis
Labyrinthitis
What TWO Sx of vestibular neuronitis may be present after vertigo resolves?
- Facial weakness
2. Dizziness/Imbalance
What is the presumed etiology of vestibular neuronitis?
Viral
How is vestibular neuronitis treated pharmacologically?
What non-pharmacological management options are used to treat vestibular neuronitis?
- Vestibular suppressants/antiemetics in the acute phase ONLY
- Steroids
- Possibly antivirals
- Sodium restriction
- Vestibular rehabilitation therapy
- Driving restrictions
When would ABx be warranted in vestibular neuronitis?
Only if it were associated with acute otitis media
How would Meniere’s Syndrome present?
- vertiginous attacks lasting for hours
- Aural of fullness
- Roaring tinnitus
- Decreased hearing
Menieres Disease often results from a _______ of the endolymphatic system which can result in the degeneration of vestibular and cochlear _____ cells.
Distension
Hair
How might the audiogram look in a patient with Menieres Disease
The effected ear will show low frequency hearing loss and will normalize as the frequency of sounds increase
What is the first line treatment for Meniere’s Disease?
Sodium reduction (1500 mg a day)
How does diuretic therapy work in theory with Meniere’s Disease?
It reduces the fluid in the ear to prevent attacks
If Meniere’s becomes a chronic problem what treatment options are available?
Gentamicin Ablation
What is unique to the presentation of migranous vertigo?
- unilateral throbbing headache
- Visual Aura
- N/V, photophobia
- FHx of migraines
- History of motion sicknes
T/F: In a patient with migranous vertigo, dizziness may last a few minutes to a few hours
True
Vertigo is often an associated symptoms in a migraine _____.
Aura
