Vertigo/Instability

Question 1

What is Vertigo?

Answer 1

Sensation that the room/objects are spinning around you, whilst you are not.

Question 2

Vestibular Neuronitis

• Sx
• Mx

Answer 2

Sudden onset, lasts for several hours
Hearing not affected
Recent viral illness

Mx
Self Resolve in 3-4 weeks

Question 3

Meniere’s

- Sx

Answer 3

Recurrent, 20 minute episodes
Nausea and Vomiting
Tinnitus
Hearing loss with episode
Sudden drop to floor (no LOC)

Question 4

BPPV

• Sx
• Mx

Answer 4

Vertigo for a few seconds after changing position of head, due to canal debris
RF: hx of trauma

Mx

• Dix-Hall-pike manoeuvre to diagnose, should induce nystagmus
• Epley manoeuvre to treat

Question 5

Drug Causes

- Mx

Answer 5

Aminoglycosides
- gentamicin

Furosemide (reversible)

Mx

• Stop Drug
• Check UEs for renal function

Question 6

Lymph Causes

Answer 6

Traumatic injury causing fistula between inner and middle ear

= Nystagmus on loud sounds

Question 7

Arterial Causes

Answer 7

Stroke
TIA
Migraine

Question 8

Neoplastic Causes

Answer 8

Acoustic Neuroma

• Ipsilateral cerebellar signs
• Early loss of hearing on affected side
• RF Neurofibromatosis type 2

Question 9

Neuro Causes

Answer 9

Complex partial seizure
- Epilepsy

Demyelination

Brain Tumour