Peripheral Vertigo
Attacks : sudden , severe, usually seconds or minutes Nystagmus: horizontorotatory, worsened by head position No neurologic findings
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BVP: Short livid, positional caused by stray otoconial particles Positive Hallpike test
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Meniere’s disease
- Tennitus
- Hearing loss
- Attacks in clusters
- Long symptom free intervals
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Vestibular neuronitis
- Severe vertigo for days
- Mild persistent positional vertigo
- No auditory symptoms
- Head thrust test +
Acoustic neuroma
- Peripheral cause that can become central vertigo hearing loss Tennitus
Central Vertigo
Attacks: gradual, mild usually continuous for weeks and months but can be sudden, severe and seconds or minutes with vascular causes
- Nystagmus: usually vertical and downbeat
- Little change with head position
- Neurologic findings usually present
- Cerebellar hemorrhage
- Hypoglycemia
- Head Truama
- Multiple Sclerosis
- Vertebrobasilar migraine
- Vertebrobasilar insufficiency; Associated with neurological abnormalities
Labyrinthitis
Acute suppurative - Toxic patient - Severe vertigo
Serous: - Inflammatory response to nearby infections
Toxic - Hearing loss - Tennitus
Chronic - Symptoms secondary to fistula