Vertigo is a symptom of impaired spatial orientation that causes feelings of giddiness, dizziness, and positional insecurity. It can be caused by problems in the inner ear (peripheral), neck (cervical), eyes (ocular), or brain (central). Evaluating a patient with vertigo involves taking a medical history and conducting examinations of the ears, neurological system, and mental status, as well as balance tests, imaging studies, and audiological tests to determine the cause and guide treatment. Vertigo has many potential underlying causes including infections, vascular issues, neurological disorders, tumors, and psychological factors.

1. VERTIGO A CLINICAL APPROACH

2. What is Vertigo ? Impaired spatial orientation Vertigo Sbjective/Objective Giddiness, dizziness, positional isecurity Oculomotor : Oscillopsia Motor abnormality: unsteadiness, fall Autonaumic dysfunction: nausea vomiting, sweating, palpitation

3. What are the types of Vertigo? Peripheral Cervical Auditary Ocular Central Brainstem Cortical Psychogenic

4. How to Investigate Vertigo? History Onset Character Severity Duration Relation to psoture and head position Association tinitus, deafness sweating, nausea vomiting, neurological and psychological signs

5. Investigaion Vertigo Cont. General Examination Pulse, BP, pallor Otological Examintation External and Ineternal ear Hearing Vestibular : Head thurst, Dix Hllpike man. Neurologic Examination Cranial nerve , Cerebellar, sensory, motor Psychologic evaluation

6. Vertigo Investigation cont. Otologic Audiometry Electornystagmography Brain stem evoked potential Neurologic CT scan, MRI EEG Angiogram CSF

7. Types of Vertigo

8. Types of Vertigo cont.

9. Neurogenic Vertigo Brainstem Vascular Vertebrobasilar Insufficiency Wallenberg’s syndrome Cerebellar infarction Cerebellar hemorrhage

10. Neurogenic Vertigo cont. Brainstem Brain stem encephalitis Multiple sclerosis Developmental Tumors : Intrinsic, Extrinsic Degenerative Migraine

11. Neurogenic Vertigo cont Supratentorial Epilepsy Trauma Cerebral tumor Psychogenic

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