Transient episodes of vertigo caused by stimulation of vestibular sense organs by canalith affects middle-age and older patients affects twice as many women as menĬyst-like lesion filled with keratin debris, most often involving the middle ear and mastoid Inflammation of the vestibular nerve, usually caused by viral infectionīenign positional paroxysmal vertigo (benign positional vertigo) Inflammation of the labyrinthine organs caused by viral or bacterial infectionĪcute vestibular neuronitis (vestibular neuritis)* Labyrinthitis (i.e., inflammation of the labyrinthine organs caused by infection) is distinct from acute vestibular neuronitis (i.e., inflammation of the vestibular nerve), and the terms are not interchangable. Much confusion surrounds the nomenclature of acute vestibular neuronitis because the term “labyrinthitis” often is used interchangeably with it. 7 Other causes include drugs (e.g., alcohol, aminoglycosides, anticonvulsants, anti-depressants, antihypertensives, barbiturates, cocaine, diuretics, nitroglycerin, quinine, salicylates, sedatives/hypnotics), 8, 9 cerebrovascular disease, migraine, acute labyrinthitis, multiple sclerosis, and intracranial neoplasms. Ninety-three percent of primary care patients with vertigo have benign paroxysmal positional vertigo (BPPV), acute vestibular neuronitis, or Ménière’s disease. 2 The differential diagnosis of vertigo ( Table 1 1 – 6 ) includes peripheral vestibular causes (i.e., those originating in the peripheral nervous system), central vestibular causes (i.e., those originating in the central nervous system), and other conditions. 1 The most prevalent type is vertigo (i.e., false sense of motion), which accounts for 54 percent of reports of dizziness in primary care. There are four types of dizziness: vertigo, lightheadedness, presyncope, and dysequilibrium. One of the most common and frustrating complaints patients bring to their family physicians is dizziness. Associated neurologic signs and symptoms, such as nystagmus that does not lessen when the patient focuses, point to central (and often more serious) causes of vertigo, which require further work-up with selected laboratory and radiologic studies such as magnetic resonance imaging. The history (i.e., timing and duration of symptoms, provoking factors, associated signs and symptoms) and physical examination (especially of the head and neck and neurologic systems, as well as special tests such as the Dix-Hallpike maneuver) provide important clues to the diagnosis. Knowing the typical clinical presentations of the various causes of vertigo aids in making this distinction. Once it is determined that a patient has vertigo, the next task is to determine whether the patient has a peripheral or central cause of vertigo. All rights reserved.Benign paroxysmal positional vertigo, acute vestibular neuronitis, and Ménière’s disease cause most cases of vertigo however, family physicians must consider other causes including cerebrovascular disease, migraine, psychological disease, perilymphatic fistulas, multiple sclerosis, and intracranial neoplasms. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.Ĭopyright © EBSCO Publishing. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY.
BENIGN POSITIONAL VERTIGO PROFESSIONAL
It is neither intended nor implied to be a substitute for professional medical advice. Please be aware that this information is provided to supplement the care provided by your physician. Accessed September 10, 2014.ĮBSCO Medical Review Board Rimas Lukas, MD Austin (Tx): University of Texas at Austin, School of Nursing 2014 May.
Evaluation of vertigo in the adult patient. : University of Texas at Austin School of Nursing, Family Practitioner Program.
BENIGN POSITIONAL VERTIGO PLUS
DynaMed Plus Systematic Literature Surveillance.
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