Vertigo and Dizziness
Terms in this set (17)
What is dizziness?
A general term describing a variety of feelings, including light-headedness, vertigo, disequilibrium, and any sensation that the patient interprets as abnormal
What is vertigo?
A specific term describing a sense of rotational motion indicating dysfunction of the vestibular pathway
What is disequilibrium?
A relatively specific term describing a feeling of "unsteadiness" or of being "about to fall," usually indicating an abnormal gait
Why should dizziness, vertigo, and disequilibrium be distinguished?
They describe different sensations, have different localizing value, and have different pathophysiologic implications.
What is syncope?
Transient loss of consciousness of cardiovascular origin; also known as "fainting"
What is presyncope?
Sensation of being about to faint
What are the 4 CNS locations where dysfunction can cause disequilibrium?
1. Whole brain (secondary either to primary CNS disorder or systemic illness), causing focal or generalized weakness
2. Cerebellum, causing incoordination
3. Basal ganglia, causing impaired postural reflexes 4. Sensory tracts or receptors, causing impaired proprioception
Where is the anatomic defect that causes peripheral vertigo?
Vestibular apparatus (semicircular canals) and vestibular nerve
Where is the anatomic defect that causes central vertigo?
Vestibular nuclei and pathways in the brainstem
What are the 2 most common peripheral causes of vertigo?
2. Labyrinthitis (also called "vestibular neuronitis")
What are the distinguishing features of BPPV?
Vertigo is positional and paroxysmal; that is, it is precipitated by specific movements of the head.
What test is performed to diagnose BPPV?
Dix-Hallpike maneuver—patient is taken from a sitting to a lying position with the head turned to the side of vestibular dysfunction; the presence of torsional nystagmus, often after a brief latency, indicates a positive test.
What is the definitive treatment for BPPV?
Otolith repositioning maneuvers - Epley maneuver
What are the 3 classic symptoms of Ménière syndrome?
3. Paroxysmal vertigo
List the 2 most common causes of central vertigo
1. Vertebrobasilar TIA or stroke
2. Brainstem tumor
What clinical feature distinguishes central from peripheral vertigo?
Central vertigo is usually accompanied by other brainstem dysfunction.
What are the 2 drugs that are useful in the treatment of all types of vertigo?
Meclizine and benzodiazepines (especially diazepam)
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