vertigo common causes

• related: Neurology
• tags: #neurology

BPPV

• Path: otolith
• symptoms: recurrent, reproducable vertigo lasting < 1 min
• diagnosis: Dix-Hallpike, look for rotary nyastagmus
• treatment: Epley

Vestibular Neuritis or labyrinthritis (+hearing loss)

• path: viral (herpes)
• symptoms:
  • 4 weeks after URI
  • single episode
  • vertigo can last for days
  • maybe unilateral hearing loss (labyrinthritis)
  • maybe NV
• diagnosis:
  • positive head-thrust test: In this test, the patient focuses on the examiner's nose while the examiner quickly rotates the patient's head 10-15 degrees to the side; normally, the eyes remain fixed on the target, but in a patient with a peripheral vestibular disorder, the eyes initially rotate with the head before voluntarily redirecting back to the target (corrective saccade).
• treatment: steroids, anti-vertigo (meclizine), acyclovir for herpes

Meniere

• path: unknown
• symptoms:
  • hearing loss, tinnitus, vertigo; >30 min, < 1hr.
  • Chronic, episodic recurrent vertigo
• diagnosis: clinical
• treatment: salt restriction, thiazide, anti-vertigo