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Vertigo

Vertigo. Dr. Victor James Abdullah. Proprioceptors. Vestibular Organ. Vestibular Hair Cells. Semicircular Canals. AICA. Causes of Vertigo. Trauma Infection Vascular Metabolic Dysequilibrium of ageing Psychogenic/Hyperventilation Tumour Meniere’s BPPV. Trauma. Proprioceptors.

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Vertigo

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  1. Vertigo Dr. Victor James Abdullah

  2. Proprioceptors

  3. Vestibular Organ

  4. Vestibular Hair Cells

  5. Semicircular Canals

  6. AICA

  7. Causes of Vertigo • Trauma • Infection • Vascular • Metabolic • Dysequilibrium of ageing • Psychogenic/Hyperventilation • Tumour • Meniere’s • BPPV

  8. Trauma

  9. Proprioceptors

  10. Traumatic

  11. Trauma • Iatrogenic • Head Injury • -Temporal bone # • Whiplash • Perilymph Fistula

  12. Infection

  13. Proprioceptors

  14. Infection • Viral • -Vestibular neuritis • -Viral labyrinthitis • -Herpes Zoster Oticus • Bacterial • -CSOM • -Syphilis

  15. Vascular

  16. Proprioceptors

  17. Vascular • CVA • Migraine • -Vertebrobasilar Migraine • VBI • Vasculitis • Subclavian Steal Syndrome

  18. Subclavian Steal Syndrome

  19. Wallenburg Syndrome

  20. Drugs

  21. Drugs • Aminoglycosides • Alcohol • Mercury poisoning • Loop diuretics

  22. Metabolic

  23. Proprioceptors

  24. Metabolic • Anaemia B12 • DM • Hypothyroidism • Hypercholestrolaemia

  25. Dysequilibrium of Ageing

  26. Dysequilibrium of Ageing • No de novo Meniere’s if >65yrs • multi-sensory deficits • vestibular sedatives not useful • vestibular rehabilitation program • a walking stick

  27. PsychogenicHyperventilation

  28. Tumours

  29. Tumours • Vestibular Schwannoma

  30. Meniere’s DiseaseBPPV

  31. Meniere’s SyndromeMeniere’s Disease

  32. Prosper Meniere

  33. Meniere’s disease Pathogenesis: over-accumulation of fluid within the inner ear Meniere’s disease Normal

  34. BPPV

  35. Pathophysiology

  36. Diagnosis confirmed by Dix Hallpike maneuver

  37. Benign Paroxysmal Positional Vertigo(BPPV) • Drugs: USELESS • Treatment of choice: Epley maneuver

  38. 30 Seconds each step

  39. History • Nature • Duration • Associated symptoms • Trauma Drugs Medical History

  40. Examination • Gait • ENT Nystagmus+Corneal reflex • Past Pointing • Heel Toe • Romberg’s • Unterberger • Hallpike’s if relevant + Epley’s

  41. Peripheral Nystagmus • Unidirectional • Fatiguable • Abolished by optic fixation • Compensated for in time

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