Vertigo

Question 1

characteristics of vertigo

Answer 1

• illusion of movement (usually rotation) of patient or surroundings
• worse on movement

Question 2

symptoms often confused with vertigo

Answer 2

faintness
light-headedness
lost awareness

Question 3

acronym for causes of vertigo

Answer 3

IMBALANCE
Infection/Injury
Meniere's
Benign Positional Vertigo
Aminoglycosides
Lymph, Peri, fistula
Arterial
Nerve
Central lesions
Epilepsy

Question 4

Causes of Vertigo: Infection

Answer 4

labyrinthitis (post viral severe vertigo, n/v)

Ramsay Hunt

Question 5

Causes of Vertigo: Injury

Answer 5

trauma to petrous temporal bone

Question 6

Causes of Vertigo: Meniere’s

Answer 6

• Endolymphatic hydrops
• Recurrent vertigo (~20min) ± n/v
• Fluctuating SNHL
• Tinnitus
• Aural fullness
• an antihistamine may be useful if prolonged
• severe disease may be treated with vestibular organ ablation using gentamicin

Question 7

Causes of Vertigo: Benign Positional Vertigo

Answer 7

sudden vertigo for a few seconds provoked by head rotation

• canalolithiasis
• nystagmus on performing Hallpike-Dix manoeuvre
• can treat with Epley manoeuvre

Question 8

Causes of Vertigo: lymph, peri-, fistula

Answer 8

• Path: Connection between inner and middle ears
• Causes: Congenital, trauma
• PC: vertigo, SNHL
• o/e: Tullio’s phen – nystagmus evoked by loud sound

Question 9

Causes of Vertigo: arterial

Answer 9

migraine

TIA/Stroke

Question 10

Causes of Vertigo: Nerve

Answer 10

acoustic neuroma/vestibular schwannoma

Question 11

Causes of Vertigo: central lesions

Answer 11

demyelination
tumour
infarct (e.g. lateral medullary syndrome)

Question 12

Causes of Vertigo: epilepsy

Answer 12

complex partial