Vertigo

Resident Survival Guide Vertigo in Children

Vertigo Microchapters
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Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Vertigo from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Study of Choice
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Zehra Malik, M.B.B.S[2]

Synonyms and keywords:

Classification

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Classification of Vertigo

Based on Location of Dysfunction

Peripheral

Central

Lesion in inner ear or vestibulocochlear nerve

Lesion in brainstem or cerebellum

Meniere’s disease Benign positional paroxysmal vertigo Acute labyrinthitis Acute vestibular neuronitis Cholesteatoma Otosclerosis Perilymphatic fistula Acoustic Neuroma

Brainstem Stroke Vestibular Migraine Multiple Sclerosis damage to the cerebellum Cerebellar tumors lateral medullary syndrome Chiari malformation

Causes

• Peripheral causes of vertigo includes:

Disease	Pathophysiology	Main Feature
Ménière’s disease	Increased endolymph volume in semicircular canals	Recurrent vertigo, aural fullness, hearing loss and tinnitus
Benign positional paroxysmal vertigo	Dislodged otoliths stimulate vestibular sense organ	Recurrent vertigo, nausea, vomiting, torsional nystagmus
Acute labyrinthitis	Inflammation of labyrinth/ viral or bacterial	Temporary hearing loss, vertigo, off balance, tinnitus
Acute vestibular neuritis	Inflammation of vestibular nerve caused by viral infection	Vertigo, hearing intact
Cholesteatoma	Cyst/sac of keratin debris in middle ear	Fullness/pressure in the ear, vertigo, hearing loss, pain
Otosclerosis	Abnormal bone growth in middle ear	Vertigo, tinnitus and, sensorineural hearing loss
Perilymphatic fistula	Abnormal connection between the middle ear and inner ear	Fullness/pressure in the ear, vertigo, hearing loss/sensitive hearing

Differentiating Vertigo from other Diseases

• Vertigo must be differentiated from other diseases that cause imbalance, dizziness, and lightheadedness.

Epidemiology and Demographics

• Among the patient who presents with dizziness in the primary care setting, fifty-four percent have vertigo upon investigation.