vertigo common causes

BPPV

  • Path: otolith
  • symptoms: recurrent, reproducable vertigo lasting < 1 min
  • diagnosis: Dix-Hallpike, look for rotary nyastagmus
  • treatment: Epley

Vestibular Neuritis or labyrinthritis (+hearing loss)

  • path: viral (herpes)
  • symptoms:
    • 4 weeks after URI
    • single episode
    • vertigo can last for days
    • maybe unilateral hearing loss (labyrinthritis)
    • maybe NV
  • diagnosis:
    • positive head-thrust test: In this test, the patient focuses on the examiner's nose while the examiner quickly rotates the patient's head 10-15 degrees to the side; normally, the eyes remain fixed on the target, but in a patient with a peripheral vestibular disorder, the eyes initially rotate with the head before voluntarily redirecting back to the target (corrective saccade).
  • treatment: steroids, anti-vertigo (meclizine), acyclovir for herpes

Meniere

  • path: unknown
  • symptoms:
    • hearing loss, tinnitus, vertigo; >30 min, < 1hr.
    • Chronic, episodic recurrent vertigo
  • diagnosis: clinical
  • treatment: salt restriction, thiazide, anti-vertigo