Superior semicircular canal dehiscence should be differentiated from post-traumatic vertigo it is characterized by episodes of vertigo associated with loud sounds and/or altered middle-ear pressure. Perilymphatic fistula of the round window. Al Felasi M, Pierre G, Mondain M, et al. Vestibular dysfunction after cochlear implantation. Other causes are postsurgical (middle-ear surgery, cochlear implantation) and diving. Patients may complain of vertigo, disequilibrium, tinnitus, pressure, headache, and diplopia. Diagnosis and management of post-traumatic vertigo. Presenting symptoms may be of a traumatic perilymphatic fistula or post-traumatic Meniere disease. Typically, occurs as a result of blunt head trauma such as a fall, an assault, or a motor vehicle accident. Urgent magnetic resonance imaging should be requested in all patients with acute vertigo who have significant risk factors for a cerebellar stroke, such as hypertension, diabetes mellitus, smoking, and cardiovascular disease, since it is possible that central signs on exam may not present. Differentiating between peripheral and central causes of vertigo. Unlike peripheral causes, the head-impulse test is negative (no saccadic adjustment of the eyes on sudden head twisting). Patients with cerebellar stroke usually cannot stand without support, even with the eyes open, whereas a patient with acute vestibular neuritis or labyrinthitis is usually able to do so. Other neurologic signs include limb ataxia and impaired gait. Nystagmus (bilateral or vertical) may suggest a central cause of the vertigo. Cerebellar stroke (due to infarction or hemorrhage) may present in a similar fashion to peripheral causes of vertigo with sudden intense vertigo, nausea, and vomiting.
2011 4:183-191.ĭizziness is a common presenting feature in cerebrovascular events. Management is similar to the recommended treatment of migraine headaches, and includes dietary and lifestyle modifications, and prophylactic therapies (beta blockers, calcium channel blockers, and tricyclic antidepressants). Photophobia, phonophobia, or aura may be diagnostic symptoms. Symptoms include spontaneous and positional vertigo, head motion vertigo/dizziness and ataxia, all of variable duration, ranging from seconds to days, and independent of migraine associated headache. It affects approximately 10% of patients with migraine. Related conditionsĪ common cause of vertigo and the most common cause of spontaneous episodic vertigo. However, those few central causes (vascular and neoplastic) are emergencies that should not be overlooked. Most causes of vertigo are peripheral and non-life-threatening. 2009 Spring 9(1):20-6.ĭepending on the underlying cause/condition, it may be associated with nausea and vomiting, or accompanied by other symptoms and signs (e.g., headaches and visual symptoms). Vertigo: a review of common peripheral and central vestibular disorders. Vertigo may result from diseases of the inner ear or disturbances of the vestibular centers or pathways in the central nervous system (e.g., Meniere disease, arteriosclerosis of cerebral vessels, brain lesion, head injury, motion sickness, or large and rapid variations in barometric pressure). True vertigo is described as a rotary sensation of the patient or surroundings, and is often of vestibular origin. The term is sometimes used erroneously to mean any form of dizziness.
Vertigo is the sensation that the environment is spinning around relative to oneself (objective vertigo) or vice versa (subjective vertigo).
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