Vertigo

Description

Specials (ENT) Flashcards on Vertigo, created by Liam Musselbrook on 06/12/2016.
Liam Musselbrook
Flashcards by Liam Musselbrook, updated more than 1 year ago
Liam Musselbrook
Created by Liam Musselbrook almost 8 years ago
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Resource summary

Question Answer
What are nystagmus? Involuntary conjugated rhythmic to and fro movement of the eyes
Slow and fast components of nystagmus Irritant: Slow component towards lesion and fast away Da
Benign Paroxysmal Positional Vertigo (BPPV): features Vertigo triggered by change in head position (e.g. rolling over in bed or gazing upwards) May be associated with nausea Each episode typically lasts 10-20 seconds Positive Dix-Hallpike manoeuvre
BPPV: management Usually resolves spontaneously after a few weeks to months Symptomatic relief may be gained by: - Epley manoeuvre (80% success rate) - Teaching the patient exercises they can do themselves at home, for example Brandt-Daroff exercises
What are the causes of labrynthitis/vestibular neuronitis? Usually viral Bacterial Acute localised ischaemia
How might viral labrynthitis present? Recent viral infection Sudden onset Nausea and vomiting Hearing may be affected
How might vestibular neuritis present? Recent viral infection Recurrent vertigo attacks lasting hours or days No hearing loss
How does one manage vestibular migraines? Amitriptyline at night
Presbytasis Elderly Epsiode of unsteadiness last a few seconds Worse on movement No LoC or N+V Improves spontaneously
Describe the typical case of vertebrobasilar ischaemia Elderly patient Dizziness on extension of neck
Central causes of vertigo Space-occupying lesion Multiple sclerosis Cerebellar degeneration Head injury Alcohol, Barbiturates Vertebro-basilar ischaemia
Presentation of acoustic neuroma Hearing loss, vertigo, tinnitus Absent corneal reflex is important sign Associated with neurofibromatosis type 2
Features of Meniere's disease Recurrent episodes of vertigo, tinnitus and hearing loss (sensorineural) Vertigo is usually the prominent symptom Sensation of aural fullness or pressure Other features include nystagmus and a positive Romberg test Episodes last minutes to hours Typically symptoms are unilateral but bilateral symptoms may develop after a number of years
Prognosis of Meniere's disease Most resolve within 5-10 years Majority of patients will be left with a degree of hearing loss Psychological distress is common
Management of suspected Meniere's disease ENT assessment Notify DVLA Acute attacks: buccal or intramuscular prochlorperazine Prevention: betahistine
What medication is given to treat motion sickness? 1st line - hyoscine 2nd line - cyclizine 3rd line - promethazine
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