VERTIGO

                             VERTIGO

Vertigo is a feeling like  everything is spinning around you. It is a feeling like dizziness but a little more than that. But one should find it out if

• it lasts in seconds ( usually benign positioning vertigo ) if there is no CNS SIGNS present.
• if it stays for hours then the cause is migraine.
• if it stays for days then there must be
•   Central Nervous System cause;

• VIII th NERVE disorder.
• Brainstem Vestibular Nuclei.
• Medium longitudenal fasciculus.
• Cerebellum.
• Vesibulospinal tract. 

•                                                                                                                                                                               

                                                           PERIPHERAL CAUSES                         

• Menieres disease
• Benign positional posture vertigo                             
• vestibular failure                                                     
• Labyrinthitis                                                               

                                                                CENTRAL CAUSES

• Multiple sclerosis 
• Head injury
• Inner ear syphillis
• Vertibrobasilar insfficiency
• Acoustic neuroma   

Peripheral vertigo is often  severe, and may be accompained by nausea and vommiting hearingloss, tinnitus (ringing noise), Nystagmus (horizontal or vertical involuntry eye movements,  Hearing loss and tinnitus is less common in central cause.

Treatment: 

 Gentamycin for neuronitis, diuretics, co-trimoxazole, metronidazole for central and Ototoxic.

BENIGN POSITIONAL VERTIGO

Attacks of sudden rotational vertigo lasting around 30sec, are provoked by head turning. It is common after head injury.
pathogenesis illness Displacement of Otoconia in the semicircular canals Causes: Head injury; spontaneous labyrinthine degeneration; postviral illness; stapes surgery( peri lymph leak ), middle ear disease.

Diagnosis:    Hallipike test. This is a manoeuvre  test it rotates the semicircular canal in the plane of gravity by positioning or repositioning the head and the body posture by sitting or lying down.
Treatment ususally self limiting within months. If persistent, try physio- therapy.
Decrease alcohol intake, sedatives, antidepressions and betahistines helps.