Vestibular Dysfunction

Question 1

What are the 3 main causes of dizziness

Answer 1

• Otologic
• Neurologic
• General medical

Question 2

What are some(4) otologic causes of dizziness?

Answer 2

BPPV
Vestibular Neuritis
Superior Canal Dehiscence
Meniere’s

Question 3

What are some (4) causes of neurologic dizziness?

Answer 3

Vertibrobasilar insufficiency
Stroke
Migrain
Low CSF

Question 4

What are some (3) general medical causes of dizziness?

Answer 4

Low B12
Orthostatic Hypotension
Hypoglycemia

Question 5

Discrepancy between systems involved in balance control can result in?

Answer 5

Nausea or dizziness

Question 6

What are the three input mechanisms for balance?

Answer 6

Vision
Vestibular
Somatosensory

Question 7

What is the ampulla?

Answer 7

The bulbous bony opening that houses the cupula

Question 8

What is the bulbous bony opening that houses the cupula called?

Answer 8

The ampulla

Question 9

What is the cupula?

Answer 9

Senso/sail that houses hair cells

Question 10

What houses the hair cells?

Answer 10

Cupula

Question 11

What are the names of the semi-circular canals?

Answer 11

Anterior
Posterior
Lateral (horizontal)

Question 12

Issues in what structures may cause peripheral vestibular issues?

Answer 12

Vestibular apparatus
Vestibular portion of CN VIII
Cerebellopontine angle tumors

Question 13

Issues in what structures may cause central vestibular issues?

Answer 13

Vestibular nuclie
Central pathways
Cerebellopontine angle tumors

Question 14

What may cause both central and peripheral vestibular signs?

Answer 14

Cerebellopontine angle tumors

Question 15

What are some peripheral vestibular diagnoses?

Answer 15

Acoustic neuroma
Meniere's disease
Gentamicin otolithic ablation
Guillain Barre
BPPV
Vestibular Neuritis
Perilymphatic Fistula

Question 16

What is the most common cause of vertigo

Answer 16

BPPV

Question 17

What brings on episodes of BPPV?

Answer 17

Rapid change in head position

Question 18

Which gender gets BPPV more often?

Answer 18

Women

Question 19

How long does vertigo typically last in BPPV?

Answer 19

30 seconds - 2 min

Question 20

Is it common for BPPV to have spontaneous remission?

Answer 20

yes

Question 21

Can BPPV be reccurent

Answer 21

yes

Question 22

What is cupulolithiasis?

Answer 22

Otoconial material gets stuck in the cupula

Disrupts cupula’s response to gravity

Question 23

What is canalithiasis?

Answer 23

Otoconial debris gets into a semicircular canal

Creates a suction moment that acts on the cupula

Question 24

Which canal is more likely to be effected by canalithiasis, posterior or lateral?

Answer 24

posterior

Question 25

BPPV generally runs its course over a period of ________

Answer 25

6-12 months

Question 26

Are antiveriginous drugs effective against BPPV?

Answer 26

no

Question 27

If BPPV persists, an MRI may be indicated. Why?

Answer 27

To rule out acoustic neuroma, cerebellar, or 4th ventricle tumar

Question 28

What is the 2nd most common cause of vertigo?

Answer 28

Vestibular neuritis

Question 29

Vestibular neuritis is often associated with?

Answer 29

a virus

Question 30

What 2 types of infections often are concurrent of precede vestibular neuritis?

Answer 30

upper respiratory or GI

Question 31

What ages are most often affected by vestibular neuritis

Answer 31

30-60 yo. women peak in 40's men peak in 60's

Question 32

Vestibular neuritis has a _____ onset, with prolonged ______ vertigo, which increases with movement of _______

Answer 32

Acute rotational the head

Question 33

Vestibular neuritis is associated with...

Answer 33

horizontal-rotatory nystagmus postural imablance N&V

Question 34

How is vestibular neuritis managed?

Answer 34

Vestibular suppressants Bedrest (24-72 hrs) Gradual return to function

Question 35

How long does recovery from vestibular neuritits generally take?

Answer 35

6 weeks

Question 36

How can vestibular rehab speed recovery for vestibular neuritis?

Answer 36

slowly increase ambulation general conditioning gaze stabilization exercises facilitate central compensation

Question 37

Meniere's disease

Answer 37

``` Hereditary or sporadic Distension of endolymphatic system Damage to hair cells Vestibular and auditory Tinnitus and hearing changes ```

Question 38

How long does vertigo from meniere's last, and what is it preceded by?

Answer 38

Lasts hours Preceded by ear pressure/fullness

Question 39

Medical management of Meniere's

Answer 39

Medication Diuretics Middle ear injections: gentamicin, steroids, sx NO CURE