Vertigo

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Definition

-  Spinning or rotatoary symptom often described as dizziness

 

Associated S/S

-  Central causes more likely to be ass w

-  Headache, aura

-  Cerebellar signs

-  Dysdiadochokinesia, dysmetria, nystagmus

-  Visual, sensory or motor symptoms

-  Diplopia, dysarthria, aphasia, weakness

-  Vestibulo-ocular reflex (VOR)

-  Fukuda stepping test

-  Hallpike maneuver

-  Peripheral causes more likely to be ass w

-  Tinnitus, deafness, aural fullness

 

Causes

-  Central (CNS)

-  Brain tumour

-  Brain stem, cerebellum, coretex

-Vertebrobasilar disease, stroke (AICA, PICA: Wallenburg syndrome), TIA, Arnold-Chiari malformation, MS, PD

-  Cerebelopontine angle (root entry zone)

-  Vestibular nerve: vestibular migraine, acoustic neuroma

-  Peripheral

-  Generally more well defined

-  Positional: BPPV

-  Recurrent: Menieres disease

-  Signel episode: Vestibular neuronitis

 

Ix

-  MRI DWI: stroke

-  Electronystagmography