Vertigo Electrocardiogram

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Vertigo Electrocardiogram Powered By Docstoc
Vertigo Overview
 Vertigo is the feeling that you or your
  environment is moving or spinning.
 It differs from dizziness in that vertigo
  describes an illusion of movement.
 When you feel as if you yourself are
  moving, it's called subjective vertigo,
  and the perception that your
  surroundings are moving is called
  objective vertigo.
Vertigo Causes
Vertigo can be caused by problems in the brain or
the inner ear.
Vertigo can be Central or Peripheral.
Vertigo Causes                                        cont .
I.       Benign paroxysmal positional vertigo (BPPV)
         Is the most common form of vertigo.
         Characterized by the sensation of motion initiated
          by sudden head movements or moving the head in
          a certain direction,
         This type of vertigo is rarely serious and can be
Vertigo Causes                                         cont    .
II.       inflammation within the inner ear
          (labyrinthitis or vestibular neuritis)
          characterized by the sudden onset of vertigo and
           may be associated with hearing loss.
          The most common cause of labyrinthitis is a viral
           or bacterial inner ear infection.
Vertigo Causes                                        .

III.   Meniere's disease
           triad of symptoms:
       a.     Episodes of vertigo.
       b.     Ringing in the ears (tinnitus).
       c.     Hearing loss.

IV.    Acoustic neuroma.
           A type of tumor of the nerve tissue.
           Symptoms include:
       a.     Vertigo.
       b.     One-sided ringing.
       c.     Hearing loss.
Vertigo Causes                                         cont .
V.        Blood flow to the base of the brain.
         Bleeding into the back of the brain (cerebellar
          hemorrhage) is characterized by vertigo.
VI.   As a symptom in multiple sclerosis.
VII. Head trauma and neck injury.
VIII. Migraine.
IX. Complications from diabetes.
         diabetes can cause arteriosclerosis which can lead
          to lowered blood flow to the brain, causing vertigo
Clinical Presentation
 Vertigo implies that there is a sensation of motion
  either of the person or the environment.
 This should not be confused with symptoms of
  lightheadedness or fainting.
 symptoms include a sensation of disorientation or
 In Addition:
     nausea or vomiting.
     Sweating.
     abnormal eye movements.
Clinical Presentation                               cont.

 The duration of symptoms can be from minutes to
 Symptoms can be constant or episodic.
 Onset may be due to a movement or change in position.
 History of recent head trauma.
 any new medications the patient is taking.
 The person may have hearing loss and a ringing
  sensation in the ears.
 The person might have visual disturbances, weakness,
  difficulty speaking, a decreased level of consciousness,
  and difficulty walking,
Vertigo Diagnosis
   Important Points in History:
     if the patient feels any sensation of motion, which may indicate
      that true vertigo exists. Report any nausea, vomiting, sweating,
      and abnormal eye movements.
     how long the patient has symptoms and whether they are
      constant or come and go. Do the symptoms occur when moving
      or changing positions? Is the patient currently taking any new
      medications? Has there been any recent head trauma.
     Are there any other hearing symptoms? Specifically, report any
      ringing in the ears or hearing loss.
     Does the patient have other neurological symptoms such as
      weakness, visual disturbances, altered level of consciousness,
      difficulty walking, abnormal eye movements, or difficulty
Vertigo Diagnosis                                                Cont.

   Investigation:
     CT scan if a brain injury is suspected to be the cause of vertigo.
     Blood tests to check blood sugar levels.
     use of an electrocardiogram (ECG) to look at heart rhythm may
      also be helpful.
Central vs. Peripheral Vertigo

                           Central Vertigo             Peripheral Vertigo
        Onset                      Gradual                 Usually Sudden
 Tinnitus, hearing loss             Absent                     Present
 Neighbourhood signs               Present                     Absent
    (Diplopia, cortical
blindness, dysarthria,…)
      Nystagmus             Pure, vertical, suppress      Mixed, horizontal,
                               with fixation, &        suppress with fixation, &
                               multidirectional             unidirectional
Vertigo Treatment
   The choice of treatment will depend on the diagnosis.
   Identifying and eliminating the underlying cause.
    Bacterial infection of the middle ear requires antibiotics.
    For Meniere's disease, in addition to symptomatic treatment,
     people might be placed on a low salt diet and may require
     medication used to increase urine output.
   In addition to the drugs used for benign paroxysmal
    positional vertigo, several physical maneuvers can be
    used to treat the condition.
    Vestibular rehabilitation exercises
    Particle repositioning maneuver.
Vertigo Medications
   Commonly prescribed medications for
    vertigo include the following:
       Meclizine hydrochloride (Anticholinergic )
       Diphenhydramine (Antihistamine)
       Scopolamine transdermal (Anticholinergics/Antispasmodics)
       Promethazine hydrochloride (Antihistamine)
       Diazepam