7201862
Description
Flashcards by Liam Musselbrook, updated more than 1 year ago
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Created by Liam Musselbrook
over 7 years ago
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| Question | Answer |
| What are nystagmus? | Involuntary conjugated rhythmic to and fro movement of the eyes |
| Slow and fast components of nystagmus | Irritant: Slow component towards lesion and fast away Da |
| Benign Paroxysmal Positional Vertigo (BPPV): features | Vertigo triggered by change in head position (e.g. rolling over in bed or gazing upwards) May be associated with nausea Each episode typically lasts 10-20 seconds Positive Dix-Hallpike manoeuvre |
| BPPV: management | Usually resolves spontaneously after a few weeks to months Symptomatic relief may be gained by: - Epley manoeuvre (80% success rate) - Teaching the patient exercises they can do themselves at home, for example Brandt-Daroff exercises |
| What are the causes of labrynthitis/vestibular neuronitis? | Usually viral Bacterial Acute localised ischaemia |
| How might viral labrynthitis present? | Recent viral infection Sudden onset Nausea and vomiting Hearing may be affected |
| How might vestibular neuritis present? | Recent viral infection Recurrent vertigo attacks lasting hours or days No hearing loss |
| How does one manage vestibular migraines? | Amitriptyline at night |
| Presbytasis | Elderly Epsiode of unsteadiness last a few seconds Worse on movement No LoC or N+V Improves spontaneously |
| Describe the typical case of vertebrobasilar ischaemia | Elderly patient Dizziness on extension of neck |
| Central causes of vertigo | Space-occupying lesion Multiple sclerosis Cerebellar degeneration Head injury Alcohol, Barbiturates Vertebro-basilar ischaemia |
| Presentation of acoustic neuroma | Hearing loss, vertigo, tinnitus Absent corneal reflex is important sign Associated with neurofibromatosis type 2 |
| Features of Meniere's disease | Recurrent episodes of vertigo, tinnitus and hearing loss (sensorineural) Vertigo is usually the prominent symptom Sensation of aural fullness or pressure Other features include nystagmus and a positive Romberg test Episodes last minutes to hours Typically symptoms are unilateral but bilateral symptoms may develop after a number of years |
| Prognosis of Meniere's disease | Most resolve within 5-10 years Majority of patients will be left with a degree of hearing loss Psychological distress is common |
| Management of suspected Meniere's disease | ENT assessment Notify DVLA Acute attacks: buccal or intramuscular prochlorperazine Prevention: betahistine |
| What medication is given to treat motion sickness? | 1st line - hyoscine 2nd line - cyclizine 3rd line - promethazine |
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