Treatment with heparin and warfarin was begun. A few transient episodes of diplopia occurred, each lasting 30 to 60 seconds, and there was one bout of vertigo, with buzzing in the ears. The patient's condition improved, and he was discharged on the fourth hospital day with instructions to take dalteparin sodium and warfarin without aspirin.
The characteristic jerky movement of the eye observed at the start and end of a period of rotation .
It is actually a reflex that maintains visual fixation on stationary points while the body rotates, although it is not initiated by visual impulses and is present in blind individuals.
Nystagmus is frequently horizontal (ie, the eyes move in the horizontal plane), but it can also be vertica l (when the head is tipped sidewise during rotation) or rotatory (when the head is tipped forward).
By convention, the direction of eye movement in nystagmus is identified by the direction of the quick component.
Peripheral or Central? Extremely common(….) None Associated CNS abnormalities Usually absent Often present Tennitus/deafness No inhibition Inhibits nystagmus and vertigo Visual fixation May be vertical Never vertical or torsional Nystagmus Often mild Marked Severity Central Peripheral Sign&Symp
About three-fourths of vestibular disorders are peripheral (inner ear and vestibular nerve).
The most common peripheral vestibular disorder is benign paroxysmal positional vertigo, followed by uncompensated Ménière disease, vestibular neuritis, labyrinthitis, perilymphatic fistula, and acoustic neuroma.
The most common central causes of dizziness and vertigo are cerebrovascular disorders , cerebellar disease, migraine, multiple sclerosis, tumors of the posterior fossa, neurodegenerative disorders, medications, and psychiatric disorders.
secondary to brainstem or cerebellar ischemia usually lasts for 20 min to 24 h and is often associated with other brainstem characteristics, including diplopia, autonomic symptoms, nausea, dysarthria, dysphagia, or focal weakness.
Patients with cerebellar disease are frequently unable to ambulate during acute episodes of vertigo.
Patients with peripheral vertigo can usually ambulate during episodes and are consciously aware of their environment.