Week 10 Summary Neuro PDF

10.3 VR: common peripheral conditions dizziness-the prob -attributed to diff systems: vertigo of central peripheral etiology, presyncope of cardiovascular non-cardiovascular etiology, disequilibrium, other or nonspecific. acute peripheral vestibulopathy unilateral peripheral vestibular conditions ar...

10.3 VR: common peripheral conditions dizziness-the prob -attributed to diff systems: vertigo of central peripheral etiology, presyncope of cardiovascular non-cardiovascular etiology, disequilibrium, other or nonspecific. acute peripheral vestibulopathy unilateral peripheral vestibular conditions are the most common cause of dizziness w BPPV being the primary offender. ménière’s disease : chronic incurable vestibular disorder 1995 by the Committee of Hearing and Disequilibrium of the American Academy of Otolaryngology-Head and Neck Surgery as the “idiopathic syndrome of endolymphatic hydrops.” meniere's disease produces a recurring set of symptoms as a result of abnormally large amounts of fluid called endolymph collecting in the inner ear. can develop at any age but more likely in adults bw ages 40 to 60 symptoms quite severe for 30 mins to 24 hrs & abate by 3 days. during an attack of early stage symptoms include: -spontaneous -violent vertigo -fluctuating hearing loss and -ear pressure or oral fullness w tinnitus. research has shown that has been linked to improper fluid drainage, abnormal immune response, allergies, viral infection, head trauma, migraines and genetics. pts dont benefit from PT during an attack but may benefit from vestibular rehabilitation in bw attacks to optimize the body *important to remember that Meniere's disease is a recurring disease in the sense that these attacks will have a repeat over the course of years. vestibular neuritis disorder resulting from a viral infection that inflames the CN 8, the vestibular cochlear nerve. resulting in dizziness or vertigo, but potentially no change in hearing. individuals w VN or labyrinthitis, may have a hx of a prior viral infection. vestibular labyrinthitis inflammation of the labyrinth, affects both branches of the vestibular cochlear nerve, disrupting the transmission of sensory info from the ear to the brain from both vestibular and auditory branches. result in: -vertigo -dizziness -difficulties with balance, -changes in hearing -potentially affecting vision -no specific PT sets that exist to dx or differentiate bw vestibular neuritis or labyrinthitis, therefore a process of elimination is necessary to diagnose the condition bc symptoms of an inner ear virus often mimic other medical problems, a thorough examination is necessary to rule out other causes of dizziness, such as : -stroke -head injury -cardiovascular disease -allergies -side effects of prescriptions or nonprescription drugs which include alcohol, tobacco, caffeine, and other illegals, neurological disorders and anxiety acoustic neuroma/schwannoma : cause symptoms of vertigo if the tumor begins to impede on the vestibular system, particularly the vestibular nerve. during tumor resections, pts may also be at risk of damaging the vestibular nerve too presentation: imbalance and vertigo, along with auditory symptoms such as tinnitus or hearing loss. otitis media/sinusitis : inflammation in middle ear inflammation can lead to buildup of fluid pressure on vestib system in inner ear and potentially cause vertigo bilateral vestibular hypofxn or complete loss (peripheral) pts that have bilateral loss of vestibular nerve fxn due to a single cause typically have been consuming ototoxic medications such as -gentamicin, -aminoglycosides antibiotics, or other global causes such as -trauma, -inflection, - autoimmune disease - pathological aging. only 1.6% of vertigo cases are attributed to bilateral peripheral hypofunction. present w bilateral loss or impaired vestibulo-ocular reflex. differential dx of common peripheral vestibular conditions table summarizes presentations and symptoms of the more common conditions affecting the peripheral vestibular system. important to know anatomy that could be impacted by a particular condition, it would likely lead you to better understanding of what the impairments or resulting symptoms attempting to diagnose a patient, important to question the duration and quality of the vertigo, any proceeding illness or trauma, and instigating factors due to the subjective assessment. key points of the patient's hx and reporting of complaints can better guide a targeted physical or objective examination. ↓ H summary the most common cause of dizziness adults is peripheral vestibular hypofunction the common peripheral vestibular hypofunction conditions can be differentiated by frequency or duration of symptoms, provoking factors, and associated signs