Vertigo: Difference between revisions
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==Historical Perspective== | ==Historical Perspective== | ||
*Vertigo is derived from the [[Latin]] word vertō which means "a whirling or spinning movement"<ref>"Definition of vertigo". Merriam-Webster Online Dictionary.<ref/>. | |||
==Classification== | ==Classification== | ||
Revision as of 20:33, 3 December 2020
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Resident Survival Guide Vertigo in Children |
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Vertigo Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Vertigo On the Web |
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American Roentgen Ray Society Images of Vertigo |
For patient information, click here
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:
Overview
Historical Perspective
Based on Location of Dysfunction
Peripheral
Accounts for over 90% of all causes of vertigo
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
Cerebellar ischemia or hemorrhage
Cerebellar tumors
lateral medullary syndrome
Chiari malformation
Pathophysiology
Causes
- Peripheral causes of vertigo includes[1]:
| Disease | 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 |
- Central causes of vertigo includes[3]:
| Disease | Main Feature |
| Brainstem Stroke | Vertigo, imbalance, double vision, slurred speech, and altered consciousness. |
| Vestibular Migraine | Mostly unilateral severe throbbing headache, vertigo lasting minutes to hours, sensitivity to motion/light/smell/noise, nausea, vomiting, imbalance. |
| Multiple Sclerosis | Vertigo may accompany other symptoms like vision problem, fatigue, numbness/tingling, limited mobility, bladder/bowel/speech/swallowing impairment. |
| Cerebellar tumors | meningioma or schwannoma in cerebellopontine angle can cause vertigo due to pressure on vestibular nerve. |
| Lateral medullary syndrome | Results from ischemia in the lateral part of the brainstem(medulla oblongata). Associated with ataxia, nystagmus, vertigo, dysphagia, dysarthria. |
| Chiari malformation | Extension of brainstem into spinal canal. Associated with numbness/tingling of hands and feet, dysphagia, vertigo, unsteady gait, hoarseness. |
Differentiating Vertigo from other Diseases
- Vertigo must be differentiated from other diseases that cause imbalance, dizziness, and lightheadedness.[4]
Epidemiology and Demographics
- Among the patient who presents with dizziness in the primary care setting, fifty-four percent have vertigo upon investigation.[5]
Screening
- There is insufficient evidence to recommend routine screening for vertigo.
Risk Factors
- There are no established risk factors for vertigo, as it is a symptom of an underlying disease.
- However, vertigo can be prevented in some cases by controlling the underlying cause:
- In vestibular migraine recognized triggers include altered sleep patterns, menstrual cycle, chocolate, red wine, ripened/aged cheese etc.
- Avoid drugs or toxins that may cause vertigo.
Natural History, Complications and Prognosis
Diagnosis
Treatment
- ↑ 1.0 1.1 Karatas, Mehmet (2008). "Central Vertigo and Dizziness". The Neurologist. 14 (6): 355–364. doi:10.1097/NRL.0b013e31817533a3. ISSN 1074-7931.
- ↑ Guerraz, M. (2001). "Visual vertigo: symptom assessment, spatial orientation and postural control". Brain. 124 (8): 1646–1656. doi:10.1093/brain/124.8.1646. ISSN 1460-2156.
- ↑ Kerber, Kevin A. (2009). "Vertigo and Dizziness in the Emergency Department". Emergency Medicine Clinics of North America. 27 (1): 39–50. doi:10.1016/j.emc.2008.09.002. ISSN 0733-8627.
- ↑ Labuguen RH (2006). "Initial evaluation of vertigo". Am Fam Physician. 73 (2): 244–51. PMID 16445269.
- ↑ Kroenke, Kurt (1992). "Causes of Persistent Dizziness". Annals of Internal Medicine. 117 (11): 898. doi:10.7326/0003-4819-117-11-898. ISSN 0003-4819.