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  #1  
Old 02-24-2012
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Question Different types of vertigo

How to differentiate vertigo from dizziness?

How to differentiate different vertigo?

How to differentiate different dizziness?


i have hard time solving q based on these...can anyone can clarify?
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Old 02-24-2012
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well vertigo is dizziness because of ear issues...
there re other cuases of diziness like hypotension ,dehydration ,cardiac causes but specific dizziness due to ear problem is vertigo...
n different types of vertigo
re labyrinthitis,vestibular neuritis.meiniers disease n bening paroxysmal positional vertigo...
u can get detail in FA..
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Old 02-24-2012
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Let's review it together :

First of all Dizziness is a non-specific term, it could mean Light headedness(pre-syncope), Vertigo, Stroke, or Cerebellar causes.

So when patient is complaining that he is feeling Dizzy then think it could be any of those reasons. and simply by taking the history you can differentiate between them.

Now let's talk about Vertigo you have two types :
1-Central.
2-Peripheral.

how to differentiate ? again it's simple :
The major feature of Peripheral Vertigo that it has Tinnitus and Hearing loss . Where in Central vertigo you don't.
Another differentiating feature is the Nystagmus, but wait ! Doesn't it exist in both Central and Peripheral vertigo ?! well yeah it does BUT :

In Peripheral Vertigo it is a Horizontal nystagmus that suppresses with fixation(your brain is working)

In Central Vertigo it is a Vertical nystagmus that doesn't suppress with fixation(here the problem is in the brain it self)

to easy remember the direction of the nystagmus think that your eyes are moving toward your ears (peripheral) which is a horizontal movement, and toward your brain(central) which is a vertical movement.

Causes of Peripheral vertigo :
-Meniere Disease.
-Labyrinthitis.
-Benign Paroxysmal Positional Vertigo.
-Perilymphatic Fistula.

Causes of Central vertigo :
-Any cerebellar or brain-stem tumor,bleed, or ischemia.
-Drug toxicity.
-Multiple Sclerosis.

Some clues for peripheral Vertigo:
Meniere Disease : multiple episodes of vertigo associated with tinnnitus and hearing loss can last for 8 hours. could have a history of Syphilis or Head trauma.

Labyrinthitis : one long episode could last for days, most commonly after an upper respiratory tract infection.

BPPV : this one is easy just remember no hearing loss or tinnitus and associated with head movement.

Perilymphatic Fistula : will give you a history of direct blunt trauma to the ear, scuba diving, or Vigorous Valsalva maneuver.

Hope that will help you,
Best Regards,
Sam
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Old 02-24-2012
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First differentiate dizziness( a general term)..
between Vertigo( room spinning,earth rolling) and
presyncope( feeling lightheaded,blackout, or with palpitation,SOB)

then ddx Vertigo into central or peripheral

Central ( CNS origin and mostly slow onset or chronic , Cn deficits, focal neurological signs)
Peripheral ( a/w Ear, acute onset , +/- hearing loss , tinnitus

again peripheral vertigo could be
1.Meniere disease( vertigo,tinnitus,hearing loss, not inc. with head movement)
2.Labyrinthitis( post URTI,otitis media)
3.Benign paroxysmal positional vertigo ( inc. with head movement, etiology-otolith).
i hope this help
GL
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Old 02-25-2012
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@qurat21 , @mlenailer: Thanks for the info...i will go through that.

@sam88: That was a very good review...i think i should not miss any q based on vertigo now.....thanks
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Old 02-25-2012
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Another cause of peripheral vertigo isVestibular neuritis which occur 2-3 days after URT infection BUT differentiated from labrynthitis( which also occur after URT infection) by the absence of Auditory symptoms like hearing loss and tinnitus.
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Old 06-11-2013
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What is positional testing for vertigo??
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