vertigo n.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
Vertigo PowerPoint Presentation
Download Presentation
Vertigo

Loading in 2 Seconds...

play fullscreen
1 / 21

Vertigo - PowerPoint PPT Presentation


  • 191 Views
  • Uploaded on

Vertigo. Vertigo / Dizziness. Sir Terence Cawthorne said: “ Labyrinthine disturbance may make one feel like the end of the world has arrived….” Doctor said: “ dealing with dizzy patient make me dizzy”. Definitions. Dizziness (vertigo):

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Vertigo' - destiny-davenport


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
vertigo dizziness
Vertigo / Dizziness
  • Sir Terence Cawthorne said:

“ Labyrinthine disturbance may make one feel like the end of the world has arrived….”

  • Doctor said:

“ dealing with dizzy patient make me dizzy”

definitions
Definitions
  • Dizziness (vertigo):

spinning or hallucination of movement.

  • Imbalance :

unsteadiness.

  • Light headedness :

orthostatic hypotension ,syncope.

balance anatomy physiology
BalanceAnatomy & Physiology
  • Vestibular sense organ: consists of :

*three semicircular canals

( posterior ,horizontal, anterior). to detect:

angular acceleration.

*Utricle & saccule :( have otoconia embedded in a gel overlying the cilia, to detect

linear acceleration.

balance anatomy physiology1
BalanceAnatomy & Physiology
  • Inner ear ( cochlea & vestibule & vestibular nerve).
  • Vestibular nuclei (brain stem).
  • The two other inputs are:

*Vision.

*Proprioception (skin, joints ,muscle receptors ,mainly neck & ankles).

**The brain stem computerise these 3 inputs with the help of cerebellum to maintain balance (head & balance).

causes of dizziness
Causes of Dizziness
  • Otogenic (inner ear) : 50% (of dizziness causes).
  • Central (neurological) :( 5%)
  • Medical : (5%)
  • Psychological :( 15%)
  • Unknown : (25%).
otogenic 50 of all dizziness
Otogenic(50% of all dizziness)
  • BPPV :(50% of otogenic ) (begnin paroxysmal position vertigo) .
  • Meniere:( 18% of otogenic).
  • Vestibular neurinitis & Labyrinthitis:(14%).
  • Acoustic neuroma :( 10%).
  • Perilymph fistula : (rare).
  • Bilateral vestibular loss :(rare).
central or neurological 5 of all dizziness
Central or Neurological(5% of all dizziness)
  • Migraine , stroke :( 50% of neurological).
  • MS :( %5).
  • Cerebrum degeneration / chiari:(5%).
  • Head injury.
  • Meningitis.
  • Brain abscess.
medical 5 of all dizziness
Medical (5% of all dizziness)
  • Hypo/ hypertension.
  • Cardiac arrhythmia.
  • Drugs.
psychological 15 of all dizziness
Psychological(15% of all dizziness)
  • Anxiety.
  • Panic.
  • Phobia.
  • Malingering.
unknown 25 of all dizziness
Unknown(25% of all dizziness)
  • Multi sensory disequilibrium (elderly).
  • Post trauma.
  • Psychogenic.
how to diagnose
How to diagnose?
  • Confirm vertigo (spinning).
  • Duration of vertigo:
  • For seconds < minute (BPPV)
  • For hrs < 24hr (Meniere ,migraine ..).
  • For days ( Labyrithitis , vestibular neurinitis,tumours).
  • Otological signs (tinnitus, hearing loss, ear discharge, surgery,..)
  • General health ,medication .
examination
Examination
  • Otological exam ( mandatory).
  • Neurological exam (mandatory- cranial nerves)
  • Nystagmus.
  • Vestibulo-ocular refluxes :

*Hallpike (posterior canal)

*Caloric test (horizontal canal)

*Nystagmus

*ENG test

  • Vestibulo-spinal refluxes:

*Romberg

*Unterburger

*Gait

investigations
Investigations
  • Audiogram ,tempanometry, acoustic refluxes.
  • Caloric test ,ENG (electronystagmography).
  • MRI (acoustic neuroma).
  • Blood tests (? medical ).
treatment
Treatment
  • Medical treatment :

*to the causes.

*vestibular sedatives

(prochlorperazine, stemitil..)

*vestibular vasodilatations

(histamine analogues, betahistine.cinnerezin.).

treatment1
Treatment
  • Surgery:

*endolymphatic sac shunting

(damagehearing).

*vestibular neurectomy

(save hearing).

*Labyrinthectomy ( damage hearing):

-surgical.

-chemical / injection of gentamycin.

treatment2
Treatment
  • Vestibular rehabilitation:

*walking stick.

*spectacles.

*Eply manoeuvre (BPPV).

*cocksacy cawthorne exercises.

re positioning otolith for bppv eply brandt dorff manoeuvre
Re-positioning otolith forBPPV (Eply & Brandt-dorff manoeuvre)