Vertigo – Ear Problem

Last Updated on by frcemuser

Diagnosis Benign paroxysmal positional vertigo (BPPV) Vestibular neuritis Labyrinthitis Meniere’s disease
Epidemiology Can affect people of any age but commonly presents around 50 years. F > M. Affects previously well young or middle-aged adults. Affects previously well young or middle-aged adults. Occurs usually for the first time in people 20 – 60 years of age.
Aetiology Usually idiopathic, particularly in elderly people. Can be precipitated by head injury, ear surgery or following an episode of labyrinthitis. Often follows a viral infection. Often follows a viral infection. Unknown.
Pathophysiology Dislodged otolith particles moving in the semicircular canals. Inflammation of the vestibular nerve. Inflammation of the labyrinth and the vestibular nerve. Thought to be caused by endolymphatic hypertension in the inner ear.
Vertigo Episodic attacks lasting seconds (but may be described as minutes), provoked by moving the head. Spontaneous onset, lasts days – gradually improves with time. Spontaneous onset, lasts days – gradually improves with time. Spontaneous episodic attacks lasting 30 minutes to several hours, can occur in clusters with long remission periods in between.
Associated features Nausea, lightheadedness, imbalance. Nausea and vomiting. Nausea and vomiting, sudden hearing loss Tinnitus, hearing loss, aural fullness.
Examination  

Normal at rest. Hallpike

Spontaneous Spontaneous No specific clinical signs
findings manoeuvre demonstrates nystagmus (torsionally and beating towards the lowermost ear). nystagmus (usually fine horizontal). Positive head impulse test. nystagmus (usually fine horizontal). Sensorineural deafness. or diagnostic tests for Meniere’s disease.

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