Symptom analysis - Vertigo
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Vertigo is caused by several conditions including BPPV, phobic postural vertigo, central vestibular syndromes, vestibular migraine, and Meniere's disease. Examination of patients with vertigo involves assessing eye movements, ear examination, hearing tests, and balance. Special tests like the Dix-Hallpike test and caloric test help determine if vertigo is central or peripheral in nature. Treatment depends on the underlying cause and may include antihistamines, betahistine, benzodiazepines, antiemetics, calcium antagonists, anticholinergics, and addressing any presyncope symptoms.
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Dizziness
1. Dizziness can be caused by issues with balance, vision, or blood flow and can manifest as vertigo, presyncope, or disequilibrium.
2. Vertigo is a false sense of spinning or rotational movement, while presyncope involves lightheadedness and impending fainting. Disequilibrium refers to impaired balance.
3. Diagnosis involves determining if the cause is peripheral (related to balance organs) or central (in the brain) based on symptoms and presence of nystagmus.
4. Peripheral disorders like vestibular neuronitis typically cause sudden vertigo and nausea with eye movements, while central issues like stroke can have milder symptoms or progress over time.
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The document discusses dizziness, including its types (vertigo, lightheadedness, disequilibrium, syncope), symptoms (headache, vomiting, difficulty walking, vision/speech/hearing changes, fainting, numbness), causes (inner ear infection, migraine, stress, low blood sugar, postural hypotension, dehydration), risk factors (age, past episodes), complications (falling, accidents, untreated issues), and approaches to diagnosis (taking history of current and past issues and medications, performing examination, ordering investigations).
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This document summarizes the case of a 53-year-old male who experienced dizziness and vertigo after consuming blackcurrant and blueberry juice. On examination, he displayed horizontal nystagmus towards his right ear that was exacerbated by head turning. Differential diagnoses considered include peripheral causes like BPPV or vestibular neuronitis, as well as central causes like posterior fossa tumors, brainstem ischemia, or basilar migraine. The document then discusses distinguishing features, potential causes, and tests for peripheral versus central vertigo.
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An altered mental status or level of consciousness requires determining the underlying cause. The initial approach involves assessing the ABCs, giving supplemental oxygen, checking glucose, and looking for signs of infection, trauma, or drugs. Further evaluation includes detailed history, physical exam focusing on vital signs and neurological status, and diagnostic testing of blood and imaging based on suspected etiologies like metabolic derangements, medications/toxins, infections, and structural brain issues. Treatment is directed at reversing or controlling the specific cause, such as treating seizures, lowering blood pressure in hypertensive encephalopathy, or giving antibiotics for infections.
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Dizziness
1. Dizziness can be caused by issues with balance, vision, or blood flow and can manifest as vertigo, presyncope, or disequilibrium.
2. Vertigo is a false sense of spinning or rotational movement, while presyncope involves lightheadedness and impending fainting. Disequilibrium refers to impaired balance.
3. Diagnosis involves determining if the cause is peripheral (related to balance organs) or central (in the brain) based on symptoms and presence of nystagmus.
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The document discusses dizziness, including its types (vertigo, lightheadedness, disequilibrium, syncope), symptoms (headache, vomiting, difficulty walking, vision/speech/hearing changes, fainting, numbness), causes (inner ear infection, migraine, stress, low blood sugar, postural hypotension, dehydration), risk factors (age, past episodes), complications (falling, accidents, untreated issues), and approaches to diagnosis (taking history of current and past issues and medications, performing examination, ordering investigations).
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This document discusses the differential diagnosis of dizziness, listing various potential causes such as benign paroxysmal positional vertigo (BPPV), infections of the inner ear, migraines, Meniere's disease, neurological conditions, and medications as common causes. It provides details on evaluating dizziness through patient history and physical exam, focusing on tests like the Dix-Hallpike maneuver to diagnose BPPV. Treatment options are also outlined, including repositioning maneuvers like the Epley maneuver to treat BPPV.
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This document presents the case of a 40-year-old female school teacher presenting with ataxia. She has a 2-year history of swaying while standing and walking. On examination, she has signs of cerebellar ataxia including impaired finger-nose and heel-shin coordination. Testing revealed normal thyroid and vitamin B12 levels. The differential diagnosis includes inherited ataxias, hypothyroidism, vitamin B12 deficiency, and paraneoplastic syndrome. The features are most consistent with an autosomal dominant spinocerebellar ataxia given the chronic progressive symmetric ataxia with no other neurological deficits. This is likely spinocerebellar ataxia type 1 or 2 given the
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This document discusses gait disorders and their causes. It defines normal gait and describes the gait cycle. It then discusses various types of abnormal gaits such as sensory ataxia caused by disturbances in sensory input, cerebellar ataxia presenting with wide-based staggering gait, and spastic gait caused by lesions interrupting the corticospinal pathway. It also covers parkinsonian gait, multisystem atrophy presenting with features of both parkinsonism and cerebellar ataxia, and spinocerebellar ataxia which is an inherited condition. Various causes of acquired and inherited ataxias are described.
Approach to patient with altered sensorium
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This document provides guidance on evaluating and managing patients presenting with dizziness or vertigo in primary care. It emphasizes taking a thorough history to determine the type and characteristics of dizziness. Common causes of vertigo are differentiated based on timing, triggering factors, and examination findings. Key examination techniques like the Dix-Hallpike and HINTS exams are outlined. Treatment recommendations are provided for common peripheral vestibular conditions like benign paroxysmal positional vertigo and vestibular neuritis, focusing on repositioning maneuvers, medications, and vestibular rehabilitation.
Dizziness and vertigo
This document provides information on differential diagnoses and evaluations for dizziness and vertigo. It discusses potential causes related to the cochleovestibular system, nervous system, cardiovascular system and other systems. Specific conditions covered include BPPV, vestibular neuronitis, labyrinthitis, Meniere's disease, and central vertigo. It also outlines the history, physical exam, office tests, and diagnostic studies used to evaluate patients experiencing dizziness and vertigo.
Vertigo and dizziness
1) Dizziness and vertigo are common, with vertigo defined as a perception of movement and dizziness having various meanings.
2) Vertigo can be peripheral or central in origin, with peripheral vertigo arising from problems in the inner ear and central vertigo from problems in the brain or brainstem.
3) A thorough history, physical exam including tests like Dix-Hallpike, and sometimes ancillary testing can help differentiate between peripheral causes like benign paroxysmal positional vertigo or Ménière's disease versus central causes like vertebrobasilar insufficiency.
Dizzy patient 2
This document provides an overview of the approach to evaluating and diagnosing dizzy patients. It discusses taking a thorough history including details of episodes, performing a neurological and otological exam, and assessing eye movements, vestibular-ocular reflexes, and gait. Common causes of dizziness include peripheral issues like BPPV, Ménière's disease, and vestibular neuritis, as well as central causes like stroke and MS. Treatments for specific conditions like BPPV involve repositioning maneuvers to move canaliths like the Epley maneuver.
Vertigo 1
This document provides information on dizziness and vestibular testing. It includes a biography of Dr. Zuraida Zainun, an audiology expert. The document discusses taking a history for dizziness, differential diagnoses, types of dizziness sensations, characteristics of peripheral versus central vertigo, and clinical examinations. It also outlines vestibular tests like VNG, VEMP, and rotating chair, as well as rehabilitation strategies and references.
Vertigo
The document discusses the evaluation and management of dizziness and vertigo. It outlines the main categories of dizziness including otologic, central, medical, and unlocalized causes. Evaluation involves taking a thorough history, performing a physical exam including tests of nystagmus, and ordering investigations like an audiogram or MRI. Common diseases discussed in more detail include benign paroxysmal positional vertigo (BPPV), vestibular neuritis, Meniere's disease, and migraine-associated vertigo. Treatment focuses on treating the underlying cause, patient education, rehabilitation, and medications in some cases.
Vestibular disorder 1 (1).pptx
The vestibular system helps control balance and eye movements. Damage to the system can cause vestibular disorders with symptoms like vertigo, dizziness, imbalance, and vision or hearing changes. Common vestibular disorders include BPPV, labyrinthitis, and Meniere's disease. Assessment of vestibular function includes tests of vision, balance, neurological function, and vestibular reflexes to evaluate disorders like BPPV, labyrinthitis, and other conditions that affect the inner ear and balance.
Central vertigo recent perspectives
This document provides an overview of central vertigo from recent perspectives. It discusses the prevalence, types, causes, diagnosis, and management of vertigo. Specifically, it covers:
1) Vertigo affects 5% of general practice and 10% of ENT patients. Common causes include peripheral vestibular disorders, infections, drugs, and cervical spine issues.
2) Diagnosis involves a medical history and physical exam including balance tests like Romberg and Unterberger tests.
3) Management includes pharmacotherapy with antivertigo drugs, adaptation exercises, and surgery in some cases. Betahistine is an effective treatment that improves blood flow and reduces vertigo symptoms.
vertigo.PPTX
This document provides an overview of vertigo and dizziness. It defines different types like vertigo, dysequilibrium, and lightheadedness. It describes the anatomy of the vestibular system and its role in stabilizing gaze, controlling posture, and sensing orientation. Common causes of vertigo are then outlined, like benign paroxysmal positional vertigo (BPPV), migraine, and Meniere's disease. The diagnosis process is discussed as being acute, recurrent, or chronic. Tests include checking for nystagmus. Treatment options covered include pharmacological approaches, physical rehabilitation techniques like the Epley maneuver, and potential surgical interventions.
Vertigo in the Emergency Department
Theme of the Fortnight presentation from Dr Lucy Miller. For use of medical professionals - see full disclaimer at www.emcage.net
Dizziness
1. Identify the difference between vertigo, disequilibrium,, near-syncope, and Undifferentiated dizziness.
2. Identify helpful tests to distinguish peripheral from central vertigo.
3. Understand how to treat different kinds of vertigo
Vertigo2010
Vertigo refers to illusions of movement and is caused by problems in the vestibular system. Common causes of vertigo include BPPV, Meniere's disease, sudden hearing loss, vestibular neuritis, and labyrinthitis. Peripheral vertigo tends to be episodic with intense but brief symptoms, while central vertigo is often continuous with less intense symptoms. Treatment depends on the underlying cause but may include medications, repositioning maneuvers, physical therapy, or surgery.
TINNITUS AND VERTIGO
Definition
Classification
Causes of tinnitus
Treatment of tinnitus
Definition
Classification
Causes of tinnitus
Treatment of tinnitus
Definition of vertigo
It’s Causes
Specific Question for History
Differential diagnosis
Investigation
Management Plan
Neurological differential diagnosis...Vertigo
This document provides information on the differential diagnosis of vertigo from central nervous system causes. It discusses the pathophysiology, clinical presentation, evaluation, and treatment of various central causes of vertigo including migraine, vertebrobasilar insufficiency, cerebellar and brainstem infarction, cerebello-pontine angle tumors, and multiple sclerosis. The clinical history and physical exam aim to localize the lesion, while imaging, vestibular testing, and occasionally lumbar puncture aid diagnosis. Treatment involves managing the underlying condition, controlling risk factors, and using anti-vertigo medications.
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Symptom analysis - Vertigo
- 2. SYMPTOM ANALYSIS -VERTIGO Dr. Jyothi Reshma S
- 3. VERTIGO 17.1 15 12.3 11.4 10.1 8.3 CAUSES BPPV Phobic postural vertigo Central vestibular syndromes Vestibular migraine Meniere's disease Vestibular neuronitis
- 4. HISTORY • Vertigo/dizziness/unsteadiness • Onset • Episodic or persistent • Aggravating and relieving factors • Other associated symptoms • Family history
- 5. Examination • Eye examination : Nystagmus – significant – occurs in primary position, aymmetric or more pronounced on one side, gaze evoked, positional, latenct present, rotational, fixation suppression Pursuits and saccades • Ear examination and hearing tests • Brain stem signs (staggering ataxic gait, diplopia, facial palsy, weakness, sensory loss, numbness of face) • Postural instability and cerebellar signs • Special tests: head thrust test, caloric test, Dix-Hallpike test, supine lateral head turns; head impulse, nystagmus, test of skew (HINTS)
- 6. Central Peripheral Vertigo Constant, less severe Intermittent, severe Nystagmus +/-, uni or bidirectional +, unidirectional, fatigable Ear symptoms +/- + Brain stem signs + - Eye signs Abnormal pursuit, saccades Abnormal but spares other eye movements
- 7. EXAMINATION vestibular tests • Electrooculography or electronystagmography : corneoretinal potential • Videooculography : record eye movements in 3 D • Vestibular evoked myogenic potentials : evaluate saccular and utricular function • Video head impulse testing: eye velocity during head rotation • Posturography: evaluate vestibular visual and somatosensory systems • Rotatory chair testing: SCC, bilateral vestibular hypofunction, children
- 8. Treatment CLASS DRUG DOSE Antihistamines Promethazine Meclizine 15-25mg PO/IM BD/TID 25-50mg TID Histamine analog Betahistine 48-96mg BZD Diazepam Lorazepam 2-5mg 0.5-2mg PO/IV TID Antiemetic Prochlorperazine Metoclopramide Dimenhydrinate 5-10mg PO/IM TID 10-20mg 50-100mg TDS Calcium antagonists Cinnarizine 25-75mg TDS Anticholinergic Scopolamine 0.6mg
- 9. • Presyncope : prodomal symptom of fainting or near faint • Graying out/black out • Related to posture: postural hypotension • Not related to posture: cardiac arrhythmia (cardiac disease, CAD, CHD) • Vasovagal attacks