Vertigo

Question 1

What is dizziness?

Answer 1

A general, non-specific term to indicate a sense of disorientation

Question 2

Is vertigo the same as dizziness?

Answer 2

No, vertigo is a type of dizziness

Question 3

What is vertigo?

Answer 3

A false sensation that oneself or the surroundings are moving or spinning

Question 4

What is vertigo usually accompanied by?

Answer 4

• Nausea

- Loss of balance

Question 5

What is vertigo the result of?

Answer 5

Mismatch between the vestibular, visual and somatosensory systems

Question 6

What groups can the causes of vertigo be subdivided into?

Answer 6

• Central

- Peripheral

Question 7

What structures can be affected in central vertigo?

Answer 7

• Cerebral cortex
• Cerebellum
• Brainstem

Question 8

What structures can be involved in peripheral vertigo?

Answer 8

• Vestibular labyrinth
• Vesticular nerve
• Semicircular canals

Question 9

What are the central causes of vertigo?

Answer 9

• Cerebrovascular disease
• Migraine
• MS
• Acoustic neuroma
• Diplopia
• Alcohol intoxication

Question 10

What are the peripheral causes of vertigo?

Answer 10

• Viral labyrinthitis
• Vestibular neuritis
• BPPV
• Meniere’s disease
• Motion sickness
• Ototoxicitiy
• Herpes zoster (Ramsay Hunt)

Question 11

What drug can cause ototoxicity?

Answer 11

Gentamicin

Question 12

What does BPPV stand for?

Answer 12

Benign paroxysmal positional vertigo

Question 13

What are the risk factors for vertigo?

Answer 13

• Older age

- Past episodes of dizziness

Question 14

What sensation is experienced in vertigo?

Answer 14

Spinning whilst stationary

Question 15

What other symptoms is vertigo commonly associated with?

Answer 15

• Nausea
• Vomiting
• Unsteadiness
• Falls
• Changes to person’s thought
• Difficulty walking

Question 16

In what time frame can the symptoms of vertigo present?

Answer 16

• Insidious (persistent)

- Sudden (episodic)

Question 17

What investigations are performed in primary care for ?

Answer 17

Usually none

Question 18

What investigatiosn can be performed for vertigo in secondary care?

Answer 18

• Audiometry
• Dix-Hallpike manoeuvre
• Electronystagmography
• CT or MRI
• EEG
• LP
• Syphilis serology

Question 19

What is audiometry used for when testing for vertigo?

Answer 19

Assessing cochlear function

Question 20

What is Dix-Hallpike used for in assessing vertigo?

Answer 20

Testing for BPPV

Question 21

What can a CT or MRI be used to look for in a patient with vertigo?

Answer 21

Neurological causes

Question 22

Why may an EEG be useful in assessing a patient with vertigo?

Answer 22

To look for epilepsy

Question 23

What can an LP look for in a patient with vertigo?

Answer 23

MS

Question 24

What are the differentials for vertigo?

Answer 24

• Postural hypotension
• Pre-syncope
• Non-specific dizziness
• Disequilibrium

Question 25

What is disequilibrium?

Answer 25

When the brain receives inadequate information about the body's position from the somatosensory, visual, and vestibular systems

Question 26

What can cause disequilibrium?

Answer 26

- Peripheral neuropathy - Eye disease - Peripheral vestibular disorders

Question 27

What does the management of vertigo depend upon?

Answer 27

The underlying cause

Question 28

What general advice should be given to patients with vertigo?

Answer 28

- Don't drive when dizzy or if likely to be dizzy - Inform employer if dizziness makes work dangerous - Discuss risk of falling and discuss measures to reduce this

Question 29

What does the DVLA say with regards to vertigo?

Answer 29

People who are liable to sudden unprovoked attacks of disabling dizziness should stop driving

Question 30

What drugs could be useful in managing associated symptoms of vertigo?

Answer 30

- Prochlorperazine | - Cyclizine

Question 31

What are the potential complications of vertigo?

Answer 31

- Increased risk of falls - Confinement to home - Depression