Vestibular Disorders

Question 1

BPPV timeframe

Answer 1

Seconds

Question 2

BPPV associated s/s

Answer 2

Posturally evoked

Question 3

Vestibular Migraine timeframe

Answer 3

minutes to hours to days

Question 4

Vestibular Migraine hearing loss

Answer 4

Rare

Question 5

Vestibular Migraine : associated s/s

Answer 5

Photophobia
Aura
Headache

Question 6

Meniere’s : timeframe

Answer 6

Minutes to hours

Question 7

Meniere’s : hearing loss

Answer 7

Low frequency
Fluctuating, progressive
Usually unilateral

Question 8

Meniere’s : associated s/s

Answer 8

aural fullness

Tinnitus

Question 9

Labrynthitis : timeframe

Answer 9

Days

Question 10

Labrynthitis : hearing loss

Answer 10

Possible (effusion)

Question 11

Labrynthitis : associated s/s

Answer 11

URI prodrome

Question 12

Acoustic neuroma : timeframe

Answer 12

Days to longer

Question 13

Acoustic Neuroma : hearing loss

Answer 13

Asymmetric

Question 14

Acoustic Neuroma : associated s/s

Answer 14

Headache

Variable disequilibrium

Question 15

Superior Semi-circular canal Dehiscence Syndrome : timeframe

Answer 15

Intermittent - after noise/air pressure changes

Question 16

Superior Semi-circular Canal Dehiscence Syndrome (SCCD) : hearing loss

Answer 16

Supra-normal hearing

Question 17

Superior Semi-circular Canal Dehiscence Syndrome (SCCD): associated s/s

Answer 17

From head injury

Question 18

Perilymphatic fistula : timeframe

Answer 18

Seconds to minutes

Question 19

Perilymphatic fistula : hearing loss

Answer 19

Possible

Question 20

BPPV : hearing loss

Answer 20

NO

Question 21

Perilymphatic Fistula : associated s/s

Answer 21

Worse w/ Valsalva or ME fluid

Question 22

Vestibular neuronitis : timeframe

Answer 22

Sudden, days to weeks

Question 23

Vestibular Neuronitis : associated s/s

Answer 23

Slow, sometimes incomplete improvement

Question 24

Proper vestibular history

Answer 24

Onset
Duration
Triggers
Associated complaints
Hearing changes

Question 25

Peripheral vertigo

Answer 25

``` Inner ear Sudden onset Horizontal nystagmus N/V Fixation to suppression ```

Question 26

Central vertigo

Answer 26

Slow onset Vertical nystagmus No suppression w/ fixation

Question 27

Caloric testing

Answer 27

Cows

Question 28

Electrocochleography to dx

Answer 28

Fluid pressure of inner ear | Meniere's , endolymphatic hyrops

Question 29

Auditory brainstem response dx

Answer 29

Brainstem function | Acoustic neuroma

Question 30

Vertigo Tx

Answer 30

``` ANTIHISTIMINE DOPE - BLOCKER (metoclopramide) ANTICHOLINERGIC BENZO Meclinzine, scopolamine Steroids Salt/caffeine restrict Vestibular rehab Intratympanic steroid/endolymphatic shunt ```

Question 31

Vertigo #1 cause

Answer 31

BPPV - Peripheral Head position, one direction Resolves in seconds Intact hearing

Question 32

Where do most crystals come from

Answer 32

Otoconia from utricle to | Posterior semicircular canal

Question 33

BPPV : Dx Peripheral

Answer 33

Dix hallpike | Nystagmus towards affected side

Question 34

BPPV : Tx Peripheral

Answer 34

Eply maneuver

Question 35

Meniere's disease : s/s Peripheral

Answer 35

TINNITUS, VERTIGO, HEARING LOSS Prolonged vertigo Fluctuating H.L - low freq tilt Early stage fullness

Question 36

Meniere's : Tx Peripheral

Answer 36

Salt/caffeine restrict Benzo (acute) Diuretics - triamterene, HCTZ Oral steroid (acute), intratympanic

Question 37

2nd most common vertigo cause

Answer 37

Vestibular migraine | Peripheral

Question 38

Migraine correlates w/

Answer 38

Dizziness

Question 39

Migraine / Meniere's link

Answer 39

Vasospasm of internal auditory artery --> ischemia in labyrinth Hearing loss, ELH

Question 40

Vestibular Neuritis/Labrynthitis: presentation Peripheral

Answer 40

``` Sudden violent (continuous) vertigo N/V Hours to days +/- hearing loss Usually preceded by viral URI Nystagmus - away, rotary ```

Question 41

Vestibular Neuritis / Labrynthitis : Tx Peripheral

Answer 41

STEROIDS ANTIHISTIMINES (meclizine) Benzos Some - vestibular rehab

Question 42

Perilymphatic Fistula : where Peripheral

Answer 42

Windows in middle/inner ear | Perilymph fluid leaks in middle ear

Question 43

Perilymphatic Fistula : s/s Peripheral

Answer 43

``` Dizziness Tinnitus Hearing loss HEAD TRAUMA WORSE W/ ACTIVITY/PRESSURE/ALTITUDE ```

Question 44

Perilymphatic fistula : tx Peripheral

Answer 44

Self-heal | Surgery

Question 45

Acoustic Neuroma : present Central

Answer 45

UNILATERAL SENSORINEURAL LOSS | Tinnitus/dizziness

Question 46

Acoustic Neuroma: Dx Central

Answer 46

MRI = Dx | Romberg/Tandem Romberg towards affected side

Question 47

Acoustic Neuroma : Tx Central

Answer 47

Surgery | Stereotactic radiation

Question 48

Other central vertigo causes

Answer 48

``` Lyme Demyelinating disease CVA (basilar, cerebellar) Psychogenic CNS infxn/tumor Drugs ```

Question 49

Meniere's | types

Answer 49

``` Classical Cochlear (no dizzy) Vestibular (no hearing loss) Bilat (inner ear autoimmune) Subclin Endolympatichydrops Post trauma *years later ```