Vertigo
Which of the following is true about BPPV (Benign Paroxysmal Positional Vertigo)?
The nystagmus is not horizontal in classic BPPV. Tinnitus is not a feature and as the name suggests the symptoms and signs occur on movement.
Which of the following is TRUE about the crystals that cause BPPV (Benign Paroxysmal Positional Vertigo)?
They are formed from calcium carbonate and alter the flow of endolymph in a vestibular canal when dislodged from their normal position in the utricle and saccule.
What manouevre is shown in the video?
The Hallpike manouevre is used to diagnose BPPV (Benign Paroxysmal Positional Vertigo). Note the characteristic nystagmus. You need to do it on both sides (only 1 shown). Also it is better to sit at the end of the bed and hold their head in your hands.
What symptoms best describe an attack of Meniere's disease?
Meniere's disease is from excessive endolymph in the semi circular canals. The cause is uncertain but some attacks are thought viral in origin. Tends to be recurrent and progressive and can cause severe hearing loss. Meniere was a French doctor who died in 1862.
Only one of the following is TRUE about the movie "Vertigo". Which is it?
Directed by Alfred Hitchcock apparently it is Martin Scorsese's favourite movie. It starred Kim Novak and James Stewart. One of the cast has acrophobia--a fear of heights. Worth a look.
Which of the following findings is NOT typical of vestibular neuritis?
Epley's only works to shift otoconia crystals in BPPV. Vestibular neuronitis may be treated by steroids. The video shows characteristic horizontal nystagmus which is unidirectional usually away from the affected side.
What of the following is NEVER found in a patient with a "central"cause for their vertigo?
A positive Hallpike occurs in patients with BPPV which is a peripheral cause of vertigo. Central causes include cerebellar bleeds, posterior circulation infarctions, multiple sclerosis and vestibular migraine.
What is HINTs testing used for when it comes to looking for a cause of vertigo?
HINTs is a group of testing that is used mainly in patients who you think have vestibular neuritis (peripheral cause of vertigo). If the 4 components all show a peripheral result like vestibular neuritis then you do not have to chase a central cause with CTs/ MRIs etc.
Made up of Head impulse, Nystagmus, Test of Skew and Hearing.
Look up Peter Johns and vertigo for very good videos showing HINTs testing.
The link below is also a very good overview.
What can cause vertigo if you syringe out ear wax with water?
The water should be body temperature. If it is too cold or too hot it causes stimulation of the vestibular nerve.
Which of the following combinations of people and their phobias is INCORRECT?
Matthew McConaghy has a fear of revolving doors. The rest are correct.