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Flashcards in Vestibular Disorders Deck (49):
1

BPPV timeframe

Seconds

2

BPPV associated s/s

Posturally evoked

3

Vestibular Migraine timeframe

minutes to hours to days

4

Vestibular Migraine hearing loss

Rare

5

Vestibular Migraine : associated s/s

Photophobia
Aura
Headache

6

Meniere's : timeframe

Minutes to hours

7

Meniere's : hearing loss

Low frequency
Fluctuating, progressive
Usually unilateral

8

Meniere's : associated s/s

aural fullness
Tinnitus

9

Labrynthitis : timeframe

Days

10

Labrynthitis : hearing loss

Possible (effusion)

11

Labrynthitis : associated s/s

URI prodrome

12

Acoustic neuroma : timeframe

Days to longer

13

Acoustic Neuroma : hearing loss

Asymmetric

14

Acoustic Neuroma : associated s/s

Headache
Variable disequilibrium

15

Superior Semi-circular canal Dehiscence Syndrome : timeframe

Intermittent - after noise/air pressure changes

16

Superior Semi-circular Canal Dehiscence Syndrome (SCCD) : hearing loss

Supra-normal hearing

17

Superior Semi-circular Canal Dehiscence Syndrome (SCCD): associated s/s

From head injury

18

Perilymphatic fistula : timeframe

Seconds to minutes

19

Perilymphatic fistula : hearing loss

Possible

20

BPPV : hearing loss

NO

21

Perilymphatic Fistula : associated s/s

Worse w/ Valsalva or ME fluid

22

Vestibular neuronitis : timeframe

Sudden, days to weeks

23

Vestibular Neuronitis : associated s/s

Slow, sometimes incomplete improvement

24

Proper vestibular history

Onset
Duration
Triggers
Associated complaints
Hearing changes

25

Peripheral vertigo

Inner ear
Sudden onset
Horizontal nystagmus
N/V
Fixation to suppression

26

Central vertigo

Slow onset
Vertical nystagmus
No suppression w/ fixation

27

Caloric testing

Cows

28

Electrocochleography to dx

Fluid pressure of inner ear
Meniere's , endolymphatic hyrops

29

Auditory brainstem response dx

Brainstem function
Acoustic neuroma

30

Vertigo Tx

ANTIHISTIMINE
DOPE - BLOCKER (metoclopramide)
ANTICHOLINERGIC
BENZO
Meclinzine, scopolamine
Steroids
Salt/caffeine restrict
Vestibular rehab
Intratympanic steroid/endolymphatic shunt

31

Vertigo #1 cause

BPPV - Peripheral
Head position, one direction
Resolves in seconds
Intact hearing

32

Where do most crystals come from

Otoconia from utricle to
Posterior semicircular canal

33

BPPV : Dx

Peripheral

Dix hallpike
Nystagmus towards affected side

34

BPPV : Tx

Peripheral

Eply maneuver

35

Meniere's disease : s/s

Peripheral

TINNITUS, VERTIGO, HEARING LOSS
Prolonged vertigo
Fluctuating H.L - low freq tilt
Early stage fullness

36

Meniere's : Tx

Peripheral

Salt/caffeine restrict
Benzo (acute)
Diuretics - triamterene, HCTZ
Oral steroid (acute), intratympanic

37

2nd most common vertigo cause

Vestibular migraine
Peripheral

38

Migraine correlates w/

Dizziness

39

Migraine / Meniere's link

Vasospasm of internal auditory artery --> ischemia in labyrinth
Hearing loss, ELH

40

Vestibular Neuritis/Labrynthitis: presentation

Peripheral

Sudden violent (continuous) vertigo
N/V
Hours to days
+/- hearing loss
Usually preceded by viral URI
Nystagmus - away, rotary

41

Vestibular Neuritis / Labrynthitis : Tx

Peripheral

STEROIDS
ANTIHISTIMINES (meclizine)
Benzos
Some - vestibular rehab

42

Perilymphatic Fistula : where

Peripheral

Windows in middle/inner ear
Perilymph fluid leaks in middle ear

43

Perilymphatic Fistula : s/s

Peripheral

Dizziness
Tinnitus
Hearing loss
HEAD TRAUMA
WORSE W/ ACTIVITY/PRESSURE/ALTITUDE

44

Perilymphatic fistula :
tx

Peripheral

Self-heal
Surgery

45

Acoustic Neuroma : present

Central

UNILATERAL SENSORINEURAL LOSS
Tinnitus/dizziness

46

Acoustic Neuroma: Dx

Central

MRI = Dx
Romberg/Tandem Romberg towards affected side

47

Acoustic Neuroma : Tx

Central

Surgery
Stereotactic radiation

48

Other central vertigo causes

Lyme
Demyelinating disease
CVA (basilar, cerebellar)
Psychogenic
CNS infxn/tumor
Drugs

49

Meniere's
types

Classical
Cochlear (no dizzy)
Vestibular (no hearing loss)
Bilat (inner ear autoimmune)
Subclin Endolympatichydrops
Post trauma *years later