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afya
Vertigo
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<<forEachTiddler where 'tiddler.tags.contains(context.inTiddler.title)' sortBy tiddler.title ascending write '"*[["+tiddler.title+"]]\n"'>> <<tiddler AutoRefresh with: force>> Dizzy Sx - remember .... cerebellar - past pointing, dysdiadochokinesis ears - fullness/tinnitus/deafness (meniere - refer) BPPV - positional, look at drums sinuses - leaning forwards pulsatile tinnitus - acoustic neuroma also think of lightheadedness - postural drop BP, cardiac .... ''Viral labyrinthitis'' Recent viral infection, Sudden onset, Nausea and vomiting, Hearing may be affected Often unwell and recurs with other illnesses (?vestibular migraine - not helped by Aspirin/Triptan but Propran or Topiramate may work) ''Vestibular neuritis'' Recent viral infection, Recurrent vertigo attacks lasting hours or days, No hearing loss ''Benign paroxysmal positional vertigo'' Gradual onset, Triggered by change in head position, Each episode lasts 10-20 seconds ''Meniere's disease'' Associated with hearing loss, tinnitus and sensation of fullness or pressure in one or both ears ''Vertebrobasilar ischaemia'' Elderly patient, Dizziness on extension of neck ''Acoustic neuroma'' Hearing loss, vertigo, tinnitus, Absent corneal reflex is important sign, Associated with neurofibromatosis type 2 ''Other'' - trauma, multiple sclerosis, ototoxicity e.g. gentamicin
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