definition of dizziness
subjective sensation of movement
definition of true vertigo
subjective sensation of ROTATION
ddx dizziness
organic
non-organic
unknown
organic causes of dizziness
peripheral and central
central causes
- MS
- stroke
- tumor
- trauma
peripheral middle ear causes
- glue ear
- AOM
peripheral inner ear causes
- BPV
- mennieres
- trauma
- ototoxic drugs
peripheral cn8 causes
- vestibular neuronitis
- ramsy hunt
- acoustic neuroma
- recurrent vestibulopathy
non-vestibular neuro causes
- migraine
- alcohol
- peripheral neuropathy
non-vestibular cardiac causes
- postural hypotension
- arrhythmia
- valvular heart disease
- vertebrobasilar insuff.
non-vestibular metabolic causes
- DM
- hypothyroidism
- electrolyte imbalance
non-vestibular medication causes
- hypoglycaemics
- anti-HTN
- anti-dep
- sedatives
BPPV vertigo
lasts seconds
NO hearing loss
NORMAL- ENT and audiogram;
+ Dix Hallpike
Menieres triad
episodic vertigo-hours
SNHL- FLUCTUATING
tinnitus
treatment of menieres
- diuretics
- salt restrction
- oral betahistine
still have hearing:
- sx ablation or gentamycin
- endolymphatic sac decompression
- vestibular nerve section
have unuseful hearing:
- labrynthectomy
acute labrynthitis= vestibular neuronitis PC
vertigo + NYSTAGMUS + n/v
NO hearing loss
NORMAL- ENT and audiogram
tx of acute labrynthitis
spontaneously
- diazepam
- prochloperazine
tx vertigo
- underlying
- epley– BPPV
- dizzy meds
- vestibular rehab
- surgery
dizzy meds
SSS-CT Stemetil Serc Stugeron Cinnarizine Thiazide
vestibular rehab
if refractory to medical tx
graduated series of exercises to promote central compression
BPPV surgery, if refractory to above
posterior semi-circular canal occlusion
dx vertigo
- audiogram +/- caloric ENG–> peripheral
2. MRI–> central (MS/tumor/neuroma)
