Dominic J Mort 23/03/17 Spire Bushey Hospital
|
|
- Loreen Owens
- 5 years ago
- Views:
Transcription
1 Dominic J Mort 23/03/17 Spire Bushey Hospital
2 Dizziness Good grief!
3 Hx: Pre-syncope Dizziness As if you might faint? Vertigo Mostly about this As if on a merry-go-round? Non-rotational commoner than spinning Ataxia As if drunk? Not when sitting down
4 Case 1 38 F, mother of 3 For at least 6 months Days when feel very dizzy. Occasional waves of feeling, like being on a boat Other days not too bad More sensitive to motion sickness Movement of escalator make feel worse Otherwise well Occasional headaches since teens. Normal neurological examination Normal physical examination
5
6 Migrainous dizziness Commonest cause of recurrent dizziness Bouts may last hours to days to weeks. Symptoms vary True spinning vertigo unusual Often there is a background of non-simultaneous headaches May be other migrainous symptoms (nausea, photophobia etc) Propranolol 10 mg bd (increasing as tolerated); Amitriptyline; Pizotifen Reassurance!! Lifestyle changes. Relaxation exercises.
7 Case 2 31M taxi-driver Woke up 5AM, acute severe vertigo Vomiting ++ Wife called for ambulance
8
9 Case 2 Acute vestibular signs: No headache No neck pain - falling to right - nystagmus with his vertigo No other focal neurological signs Partial improvement over 3 days Labyrinthitis
10 Acute labyrinthitis = Vestibular neuronitis / Acute idiopathic unilateral peripheral vestibulopathy Commonest cause of acute vertigo lasting >24 hours Cause uncertain - probably post-infectious, immune-mediated Onset over mins - hours. Intense vertigo (horizontal) + vomiting Patient prefers to lie flat in bed. Symptoms even with eyes shut. Acute unilateral vestibular dysfunction. Nil else focal. Symptoms settle over days (to weeks) brainstem compensation Antiemetics (Cyclizine, Betahistine, Stemetil etc.) 2 weeks Encourage to mobilise when safe helps recovery. May need physiot
11 Case 3 55 M Fell off a ladder banging his head. A&E home 3 weeks later: Turned over in bed to silence the alarm clock Severe spinning of the room
12
13 Case 3 55 M Fell off a ladder banging his head. A&E home 3 weeks later: Turned over in bed to silence the alarm clock Severe spinning of the room Felt very nauseated. Vomited x 2 At worst for 3 mins. Signficantly better after 15 minutes Felt unsteady and nauseated all day 5 days later: Lying back in bed talking to his wife Same symptoms of nausea and dizziness, mild vertigo Next 6 weeks, intermittently Having to avoid lying flat on his back Recurrent waves of unsteadiness when moves his head Now feeling a lot better, but not back to normal
14 Examination Normal eye movements. No nystagmus Normal coordination Normal gait. Can tandem walk. Romberg s negative Unterberger s test: Equivocal Hallpike manoeuvre: Positive for the Left Left BPPV
15 Benign Paroxysmal Positional Vertigo (BPPV) Commonest cause of acute rotational vertigo. Usually positional trigger: Turning in bed. Lying back. Sitting down. Last few seconds to minutes. But disequilibrium may last longer. Most spontaneous. Also common after head trauma / immobility Repeated attacks. Positional dependence may fade. More symptomatic in patients with pre-existing vestibular impairment Diagnosis: Hallpike / Semont manoeuvre. Epley or Semont manoeuvre: 80% curative. Or vestibular exercises
16 Case 4 42M Uzbekistani businessman, visiting UK On toilet, ringing then deafness L ear As tried to walk to bed, developed acute vertigo. Vomited Noticed could not co-ordinate L hand in order to phone for help.
17
18 Case 4 Acute (left) vestibular signs: - nystagmus to right - impaired left VOR No headache No neck pain BUT Complete deafness L ear Left cerebellar ataxia Not labyrinthitis
19 Left AICA stroke
20
21
22 Effects of chronic cerebral vascular changes Whilst cerebral small vessel disease, rarely causes dizziness or vertigo, it can undermine the normal central compensation mechanisms that permit recovery from labyrinthitis or BPPV. Small vessel disease also undermines confidence walking.
23 Causes of recurrent paroxysmal vertigo Common: BPPV Migraine (vestibular migraine) Anxiety attacks (usually with hyperventilation) Very rare : Superior canal dehiscence syndrome (SCDS) Vestibular paroxysmia (neuro-vascular cross-compression) Paroxysmal brainstem symptoms in MS Epileptic vestibular aura
24 Understanding re-positioning manoeuvres for BPPV
25 Posterior Canal
26 Posterior Canal
27 Posterior Canal Utricle Cupola Ampulla
28 Posterior Canal Cupulolithiasis Utricle Cupola Ampulla
29 Posterior Canal
30 Hallpike manoeuvre Professor Adolpho Bronstein
31 Hallpike manoeuvre
32 Geotropic nystagmus
33 Semont manoeuvre Easier for older patients
34 Semont manoeuvre
35 Semont manoeuvre
The Big 3 of Vertigo
They feel it, you see it, few know it: Common vertigo conditions seen, but rarely diagnosed Peter Johns MD, FRCPC University of Ottawa pjohns@toh.ca Twitter @peterjohns84 The Big 3 of Vertigo BPPV Vestibular
More informationVertigo: A practical approach to diagnosis and treatment. John Waterston
Vertigo: A practical approach to diagnosis and treatment John Waterston Background. Vertigo is a symptom that has diverse causes. The diagnosis may remain elusive even after exhaustive clinical enquiry
More informationBenign Paroxysmal Positional Vertigo
Benign Paroxysmal Positional Vertigo Information for patients and families Read this booklet to learn about: What Benign Paroxysmal Positional Vertigo (BPPV) is Symptoms How your doctor will diagnose it
More informationBecause dizziness is an imprecise term, a major role of the clinician is to sort patients out into categories
Dizziness and Imbalance Timothy C. Hain, MD Clinical Professor of Neurology, Otolaryngology, Physical Therapy Chicago Dizziness and Hearing 645 N. Michigan, Suite 410 312-274-0197 Lecture Goals 1. What
More informationWhat could be reffered to as dizziness by the patient?
What could be reffered to as dizziness by the patient? Rotational vertigo Sense of instability Ataxia of gait Disturbance of vision Loss of contact with surroundings Nausea Loss of memory Loss of confidence
More informationCITY & HACKNEY PATHFINDER CLINICAL COMMISSIONING GROUP. Vertigo. (1) Vertigo. (4) Provisional Diagnosis. (5) Investigations. lasting days or weeks
Authors: Dr Lucy O'Rouke and Mr N Eynon-Lewis Review date: January 2017 Vertigo (1) Vertigo (2) History (3) Examination (4) Provisional Diagnosis (5) Investigations (6) Medical Cause (7) Psychiatric Cause
More informationVertigo. Tunde Magyar MD, PhD
Vertigo Tunde Magyar MD, PhD What could be reffered to as dizziness by the patient? Rotational vertigo Sense of instability Ataxia of gait Disturbance of vision Loss of contact with surroundings Nausea
More informationAcoustic neuroma s/p removal BPPV (Crystals)- 50% of people over 65 y/ o with dizziness will have this as main reason for dizziness
Dizziness and the Heart Mended Hearts Inservice Karen Hansen, PT, DPT, Cert Vestibular Rehab, CEAS Tennessee Therapy & Balance Center, LLC July 21, 2016 Balance We maintain balance with input from our
More informationWorkshop: The Assessment of Patients with Dizziness and Vertigo
Workshop: The Assessment of Patients with Dizziness and Vertigo Tamara Mijovic MD CM FRCSC Clinical Assistant Professor Department of Otolaryngology Head and Neck Surgery Otology, Neurotology & Skull Base
More informationDizziness: Neurological Aspect
Dizziness: Neurological Aspect..! E-mail: somtia@kku.ac.th http://epilepsy.kku.ac.th Features between peripheral and central vertigo 1. Peripheral Central 2.! " # $ " Imbalance Mild-moderate Severe 3.!
More informationEvaluation of the Dizzy Patient
Evaluation of the Dizzy Patient S. Andrew Josephson, MD Department of Neurology University of California San Francisco October 1, 2007 Who Sees Dizzy Patients? ED physicians Internists Neurologists ENT
More informationSasan Dabiri, MD, Assistant Professor
Sasan Dabiri, MD, Assistant Professor Department of Otorhinolaryngology Head & Neck Surgery Amir A lam hospital Tehran University of Medical Sciences October 2015 Outlines Anatomy of Vestibular System
More informationAn Introduction to Dizziness and Vertigo
An Introduction to Dizziness and Vertigo Tamara Mijovic MD CM FRCSC Clinical Assistant Professor Department of Otolaryngology Head and Neck Surgery Otology, Neurotology & Skull Base Surgery McGill University
More informationVertigo. David Clark, DO Oregon Neurology Associates Springfield, OR
Vertigo David Clark, DO Oregon Neurology Associates Springfield, OR 44F vertigo, nausea & vomiting Unidirectional Nystagmus 44F vertigo, nausea & vomiting Impaired VOR Gain to the right Vertigo History
More informationLabyrinthitis and Vestibular Neuritis
Labyrinthitis and Vestibular Neuritis http://www.patient.co.uk/health/labyrinthitis-and-vestibular-neuritis.htm Labyrinthitis and vestibular neuritis are most commonly caused by a viral infection that
More informationVestibular Differential Diagnosis
Vestibular Differential Diagnosis P R E S E N T E D B Y : S H A R I K I C K E R, P T, M P T C E R T I F I C A T E I N V E S T I B U L A R R E H A B I L I T A T I O N 2 0 1 7 L A C E Y H A L E, P T, D P
More informationEMU 2017 DIZZINESS AND VERTIGO Walter Himmel MD
EMU 2017 DIZZINESS AND VERTIGO Walter Himmel MD There is only one essential challenge in the world of dizziness and vertigo: Don t miss a posterior circulation stroke (vertebral/basilar artery) or TIA.
More informationVERTIGO. Tuesday 20 th February 2018 Dr Rukhsana Hussain. Disclaimers apply:
VERTIGO Tuesday 20 th February 2018 Dr Rukhsana Hussain WHAT IS VERTIGO? 4 Vertigo is defined as an illusory sensation of motion of either the self or the surroundings in the absence of true motion. Explaining
More informationDIZZINESS Varieties. : Fainting, hypotension : Rotatory, spinning. : Muscular incoordination : Collapse without LOC: ELH : Disturbed awareness
DIZZINESS Varieties head Syncope Vertigo Dysequilibrium Ataxia Drop attacks Confusion Panic Attacks Non-organic : Fainting, hypotension : Rotatory, spinning : Unsteadiness on moving : Muscular incoordination
More informationVertigo. Definition. Causes. (Dizziness) Benign Paroxysmal Positional Vertigo (BPPV) Labyrinthitis. by Karen Schroeder, MS, RD
Vertigo (Dizziness) by Karen Schroeder, MS, RD En Español (Spanish Version) Definition Vertigo is a feeling of spinning or whirling when you are not moving. It can also be an exaggerated feeling of motion
More informationVertigo. Definition Important history questions Examination Common vertigo cases and management Summary
Vertigo Vertigo Definition Important history questions Examination Common vertigo cases and management Summary Cases 1) 46 year old man presents two weeks after knocking his head with recurrent episodes
More informationBenign Paroxysmal Positional Vertigo (BPPV) Structures of importance. The ear is an inertial navigation device. Vestibular Reflexes
Otologic Dizziness (Dizziness from Ear) Structures of importance Timothy C. Hain, MD Northwestern University, Chicago t-hain@northwestern.edu The ear is an inertial navigation device Semicircular Canals
More informationBENIGN PAROXYSMAL POSITIONAL VERTIGO (BPPV)
5018 NE 15 TH AVE PORTLAND, OR 97211 FAX: (503) 229-8064 (800) 837-8428 INFO@VESTIBULAR.ORG VESTIBULAR.ORG BENIGN PAROXYSMAL POSITIONAL VERTIGO (BPPV) By Sheelah Woodhouse, BScPT WHAT IS BPPV? Benign Paroxysmal
More informationDizziness Cases. Martin A. Samuels Chair, Department of Neurology Brigham and Women s Hospital Boston
Dizziness Cases Martin A. Samuels Chair, Department of Neurology Brigham and Women s Hospital Boston Basic Principles Take an open ended history Know the synonyms for dizziness A patient can have more
More informationCLINICAL PRESENTATION AND RADIOLOGY QUIZ QUESTION
Donald L. Renfrew, MD Radiology Associates of the Fox Valley, 333 N. Commercial Street, Suite 100, Neenah, WI 54956 04/26/2014 Radiology Quiz of the Week # 108 Page 1 CLINICAL PRESENTATION AND RADIOLOGY
More informationDizziness: Natural Treatment for Vertigo and BPPV
Wellness and WBV Studio Home» Bodywork» Massage» CranioSacral Therapy» Dizziness: Natural Treatment for Vertigo and BPPV CRANIOSACRAL THERAPY HOLISTIC HEALING Dizziness: Natural Treatment for Vertigo and
More informationAssessing the Deaf & the Dizzy. Phil Bird Senior Lecturer University of Otago, Christchurch Consultant Otolaryngologist CPH & Private
Assessing the Deaf & the Dizzy Phil Bird Senior Lecturer University of Otago, Christchurch Consultant Otolaryngologist CPH & Private Overview Severe & profoundly deaf children & adults Neonatal screening
More informationAcute Vestibular Syndrome (AVS) 12/5/2017
Sharon Hartman Polensek, MD, PhD Dept of Neurology, Emory University Atlanta VA Medical Center DIAGNOSTIC GROUPS FOR PATIENTS PRESENTING WITH DIZZINESS TO EMERGENCY DEPARTMENTS Infectious 2.9% Genitourinary
More informationOtologic (Ear) Dizziness Fistula SCD Bilateral. Other. Neuritis BPPV. Menieres
Otologic Dizziness (Dizziness from Ear) Ear Structures of importance Timothy C. Hain, MD Northwestern University, Chicago t-hain@northwestern.edu The ear is an inertial navigation device Semicircular Canals
More informationOBJECTIVES BALANCE EVALUATION COMMON CAUSES OF BALANCE DEFICITS POST TBI BRAIN INJURY BALANCE RELATIONSHIP
OBJECTIVES Understand variables that contribute to balance deficits Understand the relationship between a brain injury and balance Become familiar with the components of a vestibular/balance assessment
More informationVestibular Function Testing
Vestibular Function Testing Timothy C. Hain, MD Professor Vestibular Tests ENG (electronystagmography) VEMP (Vestibular evoked myogenic responses) Rotatory Chair Posturography Five motion sensors can measure
More informationBenign paroxysmal positional. Labyrinth. Canalolithiasis. Specialized dizzy clinic - most frequent diagnoses. Semicircular canals
Specialized dizzy clinic - most frequent diagnoses Canalolithiasis Unclear vertigo/dizziness multisensory vertigo/dizziness Benign paroxysmal positional vertigo (BPPV) hands on unilateral vestibulopathy
More informationDIZZINESS & VERTIGO A MULTIDISCIPLINARY APPROACH
DIZZINESS & VERTIGO A MULTIDISCIPLINARY APPROACH Dr DOSH SANDOORAM MB ChB, MD, FRCS Consultant ENT Surgeon, City Clinic Group Labyrinthine disturbance may make one feel like the end of the world has arrived...
More informationProblem based review: the patient with dizziness on the AMU
240 Acute Medicine 2012 11(4): 240-245 Trainee Section Problem based review: the patient with dizziness on the AMU A Kennedy & N Cooper Abstract Unsteadiness, balance disturbance, and dizziness are common
More informationVestibular System. BAA Conference 2014 Assistant Audiologist Workshop
Vestibular System BAA Conference 2014 Assistant Audiologist Workshop Balance testing - why do we do it? Dizziness / vertigo / unsteadiness / light-headedness Very common Very distressing Nausea / vomiting
More informationChapter 19 Dizziness and Vertigo
Chapter 19 Dizziness and Vertigo Episode overview: 1) Compare characteristics of peripheral and central vertigo 2) What are risk factors for central causes of vertigo? 3) List 4 vestibulotoxic drugs. 4)
More informationBenign Paroxysmal Positional Vertigo. Jeff Walter PT, DPT, NCS
Benign Paroxysmal Positional Vertigo Jeff Walter PT, DPT, NCS Benign Paroxysmal Positional Vertigo: (BPPV) Benign = not malignant Paroxysmal = recurrent, sudden intensification of symptoms Positional =
More informationInner Ear Disorders. Information for patients and families
Inner Ear Disorders Information for patients and families Read this booklet to learn about: What are inner ear disorders Symptoms Tests you may need Treatment options Please visit the UHN Patient Education
More informationParticle Liberation Maneuvers for Benign Paroxysmal Positional Vertigo
Particle Liberation Maneuvers for Benign Paroxysmal Positional Vertigo Ahmed A. El Degwi, MD* and Ayman E. El Sharabasy, MD** ENT Department * and Audiology Unit** Mansoura Faculty of Medicine Abstract
More informationThe evaluation of a patient with dizziness
The evaluation of a patient with dizziness Kevin A. Kerber and Robert W. Baloh Neurol Clin Pract 2011;1;24 DOI 10.1212/CPJ.0b013e31823d07b6 This information is current as of December 28, 2011 The online
More informationBENIGN PAROXYSMAL POSITIONAL VERTIGO
BENIGN PAROXYSMAL POSITIONAL VERTIGO Timothy C. Hain, MD In Benign Paroxysmal Positional Vertigo (BPPV) dizziness is generally thought to be due to debris which has collected within a part of the inner
More informationDizziness is VERY Common. Dizziness is an imprecise term. Diagnostic Categories. Question. Answer 1. The Dizzy Patient Recent advances (2007)
The Dizzy Patient Recent advances (2007) Timothy C. Hain, MD Chicago Dizziness and Hearing Neurology, Otolaryngology, Physical Therapy Northwestern University, Chicago t-hain@northwestern.edu Dizziness
More informationPhysical Therapy Examination of the Acutely Vertiginous Patient. Objectives. Prevalence/Incidence of Dizziness 3/20/2018
Physical Therapy Examination of the Acutely Vertiginous Patient Andrew Wagner, PT, DPT, NCS Jennifer Williams, PT, DPT, NCS April 13, 2018 Objectives The learner will integrate basic examination principles
More informationVestibular service (balance)
The vestibular service at Addenbrooke s Hospital works closely with the Ear Nose and Throat (ENT), Neurology consultants and physiotherapists to help manage patients with dizziness/balance problems. The
More informationAn approach to vertigo in general practice
CLINICAL An approach to vertigo in general practice Sindhu Dommaraju, Eshini Perera Background Dizziness is a common and very distressing presentation in general practice. In more than half of these cases,
More informationClinical Recommendation: Assessment and Management of Dizziness Associated with Mild TBI
Clinical Recommendation: Assessment and Management of Dizziness Associated with Mild TBI Learning Objectives Understand an overview of dizziness response following mild TBI Differentiate between three
More informationPaediatric Balance Assessment
BAA regional meeting 11 th March 2016 Paediatric Balance Assessment Samantha Lear, Lead Clinical Scientist, Hearing Services, SCH overview The balance system Vestibular disorders referrals Vestibular assessment
More information2/8/2017 WHERE ARE WE? East Amherst East Aurora Hamburg West Seneca Williamsville Boulevard
2/8/2017 WHERE ARE WE? East Amherst East Aurora Hamburg West Seneca Williamsville Boulevard 1 2/8/2017 MY GOAL TODAY. 1. Provide a quick overview on falls 2. How our balance systems work 3. What treatments
More informationAcute Dizziness: Is It a Stroke? Gordon Kelley MD November 2017
Acute Dizziness: Is It a Stroke? Gordon Kelley MD November 2017 No Disclosures Dizziness Occurs in nearly ¾ of cerebellar strokes 4 categories in classic teaching*: Vertigo Presyncope Imbalance Non-specific
More informationCross Country Education Leading the Way in Continuing Education and Professional Development.
To comply with professional boards/associations standards: I declare that I or my family do not have any financial relationship in any amount, occurring in the last 12 months with a commercial interest
More informationVestibular System. Dian Yu, class of 2016
Vestibular System Dian Yu, class of 2016 Objectives 1. Describe the functions of the vestibular system: What is it? How do you stimulate it? What are the consequences of stimulation? 2. Describe the vestibular
More informationControl of eye movement
Control of eye movement Third Nerve Palsy Eye down and out Trochlear Nerve Palsy Note: Right eye Instead of intorsion and depression action of superior oblique See extorsion and elevation Observe how
More informationQuick Guides Vestibular Diagnosis and Treatment:
VNG - Balance Testing Quick Guides Vestibular Diagnosis and Treatment: A Physical Therapy Approach Dix-Hallpike Test for Diagnosis of BPPV Epley Canalith Repositioning Procedure (CRP) Semont Maneuver for
More informationDifferential Diagnosis: Vestibular Pathology. Causes of Dizziness. Benign Paroxysmal Positional Vertigo
Differential Diagnosis: Vestibular Learning objective: The participant will identify the pathologies associated with complaints of imbalance and dizziness Anne K Galgon PT, PhD, NCS Vestibular and Related
More informationHow to take the patient history
3 rd Congress of the European Academy of Neurology Amsterdam, The Netherlands, June 24 27, 2017 Hands-on Course 3 Bedside examination of the vestibular and ocular motor system - Level 2 How to take the
More informationI m dizzy-what can I expect at my doctor visit? Dennis M. Moore, M.D. Lutheral General
I m dizzy-what can I expect at my doctor visit? Dennis M. Moore, M.D. Lutheral General Dizziness and Balance is a broad area encompassing multiple fields: primary care (internal medicine, pediatrics),
More informationJMSCR Vol 04 Issue 11 Page November 2016
www.jmscr.igmpublication.org Impact Factor 5.244 Index Copernicus Value: 83.27 ISSN (e)-2347-176x ISSN (p) 2455-0450 DOI: https://dx.doi.org/10.18535/jmscr/v4i11.86 To Study the Efficacy of Homoeopathy
More informationBenign paroxysmal positional vertigo: clinical characteristics of dizzy patients referred to a Falls and Syncope Unit
Q J Med 2005; 98:357 364 Advance Access publication 8 April 2005 doi:10.1093/qjmed/hci057 Benign paroxysmal positional vertigo: clinical characteristics of dizzy patients referred to a Falls and Syncope
More informationThe Diagnosis and Treatment of Benign Paroxysmal Positional Vertigo through Particle Repositioning Manoeuvre: An Observational and Prospective Study
Original Article DOI: 10.21276/aimdr.2018.4.5.C3 ISSN (O):2395-2822; ISSN (P):2395-2814 The Diagnosis and Treatment of Benign Paroxysmal Positional through Particle Repositioning anoeuvre: An Observational
More informationSaccades. Assess volitional horizontal saccades with special attention to. Dysfunction indicative of central involvement (pons or cerebellum)
Saccades Assess volitional horizontal saccades with special attention to Amplitude? Duration? Synchrony? Dysfunction indicative of central involvement (pons or cerebellum) Dynamic Visual Acuity Compare
More informationBenign Paroxysmal Positional Vertigo (a.k.a.) Diagnosis: Dix-Hallpike Maneuver. Case SH. BPPV nystagmus. Video Frenzel Goggles make it easier
Canalith Repositioning for Benign Paroxysmal Positional Vertigo Benign Paroxysmal Positional Vertigo (a.k.a.) Timothy C. Hain, MD Departments of Neurology, Otolaryngology and Physical Therapy Northwestern
More informationPatient information from BMJ
Patient information from BMJ Last published: Jan 04, 2017 Ménière's disease The main symptom of Ménière's disease is sudden attacks of dizziness. There is no cure for this condition but there are treatments
More informationBenign Paroxysmal Positional Vertigo (BPPV)
Benign Paroxysmal Positional Vertigo (BPPV) Information for patients UHB is a no smoking Trust To see all of our current patient information leaflets please visit www.uhb.nhs.uk/patient-information-leaflets.htm
More informationORIGINAL ARTICLE. A New Physical Maneuver for the Treatment of Benign Paroxysmal Positional Vertigo
ORIGINAL ARTICLE Victor Vital, MD; Athanasia Printza, MD; Joseph Vital, MD; Stefanos Triaridis, MD; Miltiadis Tsalighopoulos, MD From the Department of Otolaryngology, Aristotle University of Thessaloniki,
More informationDizziness. Information for patients Ear Nose and Throat PROUD TO MAKE A DIFFERENCE SHEFFIELD TEACHING HOSPITALS NHS FOUNDATION TRUST
Dizziness Information for patients Ear Nose and Throat PROUD TO MAKE A DIFFERENCE SHEFFIELD TEACHING HOSPITALS NHS FOUNDATION TRUST How do we normally control our balance? Visual information Brain combines
More informationDISCLAIMER: ECHO Nevada emphasizes patient privacy and asks participants to not share ANY Protected Health Information during ECHO clinics.
DISCLAIMER: Video will be taken at this clinic and potentially used in Project ECHO promotional materials. By attending this clinic, you consent to have your photo taken and allow Project ECHO to use this
More informationBenign Paroxysmal Positional Vertigo (a.k.a.) Diagnosis: Dix-Hallpike Maneuver. Case SH. BPPV nystagmus. Video Frenzel Goggles make it easier
Positional Vertigo Office Diagnosis and Treatment Timothy C. Hain, MD Departments of Neurology, Otolaryngology and Physical Therapy Northwestern University, Chicago, IL Janet O. Helminski, PhD Physical
More informationEvaluation & Management of Vestibular Disorders
Evaluation & Management of Vestibular Disorders Richard A. Roberts, Ph.D., FAAA Alabama Hearing & Balance Associates, Inc. Disclosure and Copyright Statements Richard Roberts has no financial or nonfinancial
More informationMonitoring of Caloric Response and Outcome in Patients With Benign Paroxysmal Positional Vertigo
Otology & Neurotology 28:798Y800 Ó 2007, Otology & Neurotology, Inc. Monitoring of Caloric Response and Outcome in Patients With Benign Paroxysmal Positional Vertigo *Maria I. Molina, *Jose A. López-Escámez,
More informationV e r t i g o. T ü n d e. M a g y a r
V e r t i g o T ü n d e M a g y a r Dizziness Vestibular Proprioception Optic input (afferentation) carries not Optic input (afferentation) carries not synchronizated information to the CNS, but contradictory
More informationVESTIBULAR SYSTEM. Deficits cause: Vertigo. Falling Tilting Nystagmus Nausea, vomiting
VESTIBULAR SYSTEM Objectives: Understand the functions of the vestibular system: What is it? How do you stimulate it? What are the consequences of stimulation? Describe the vestibular apparatus, the 2
More informationPredictors of Protracted Recovery
CONCUSSION MANAGEMENT SPECIALIST ON LINE CURRICULUM Protracted Recovery and Clinical Rehabilitation All rights reserved. Sports Medicine Concepts Concussion Management Specialist Program 1 Predictors of
More informationDizziness 101 E-Class TAKE HOME POINTS
Dizziness 101 E-Class Dizziness is one of the most common reasons people seek medical care Important to consider the inner ear as a cause 5.5: Average number of providers seen if the inner ear wasn t considered
More informationThe Clinical Differentiation of Cerebellar Infarction from Common Vertigo Syndromes
REVIEW ARTICLE The Clinical Differentiation of from Common Vertigo Syndromes James A. Nelson, MD* Erik Viirre MD, PhD * University of California at San Diego, Department of Emergency Medicine University
More informationOBJECTIVES TYPES OF DIZZINESS TYPES OF DIZZINESS. Type III Disequilibrium. Classifying Common Position Sense Disturbances
OBJECTIVES Define four major types of dizziness Emphasizing vertigo Describe pathophysiology of dizziness Emphasizing BPPV Review how to cure BPPV How do you know where you are in 3-dimensional space?
More informationClassic Cases. Interesting Dizzy Cases. Case 1. Case 2. Case 3. Case 4. Timothy C. Hain, MD
Interesting Dizzy Cases Classic Cases Timothy C. Hain, MD Case 1 A 30 year old Chicago Park District Worker came in because of dizziness. He fell off of a truck two years ago, hit his head, and now he
More informationDepartment of Paediatrics Clinical Guideline. Syncope Guideline
Department of Paediatrics Clinical Guideline Syncope Guideline Definition Transient, self-limited loss of consciousness (TLOC), usually leading to falling. Onset is relatively rapid. Recovery is spontaneous,
More informationA Comparison of Two Home Exercises for Benign Positional Vertigo: Half Somersault versus Epley Maneuver
Original Paper This is an Open Access article licensed under the terms of the Creative Commons Attribution- NonCommercial-NoDerivs 3.0 License (www.karger.com/oa-license), applicable to the online version
More informationVestibular physiology
Vestibular physiology 2017 Utricle A flat epithelium: horizontal in the upright head Utricle Hair cells: no axons hair cells Utricle Hair cells synapse onto 8th nerve afferents. 8th nerve afferents Hair
More informationWhat Do You Think of My Posterior?
What Do You Think of My Posterior? Posterior Stroke and Stroke Mimics Peter Panagos, MD, FACEP, FAHA Associate Professor Emergency Medicine and Neurology Washington University School of Medicine Disclosures
More informationWelcome to Fall CE Event 2015
Welcome to Fall CE Event 2015 Basic Vestibular Function, Examination Procedures, Diagnosis, and Intervention Mark Amos, BA, DC, DACNB, FABVR What s It About? Fall prevention 6 million people/ year Balance
More informationDisclosures. Goals. Canalith Repositioning Basics to Advanced. John Li, M.D. We have no conflicts of interest to disclose.
Canalith Repositioning Basics to Advanced John Li, M.D. Disclosures We have no conflicts of interest to disclose. Goals Beginner to Epert 2 hrs into 1 Definition, History, Physical, Diagnosis, Treatment
More informationVestibular Migraine Panel Session. Panelists. Learner Objectives 7/31/2017. Steven Harvey MD. Fallon Schloemer MD.
Vestibular Migraine Panel Session David R. Friedland MD, PhD Professor and Vice-Chair Chief, Division of Otology and Neuro- Otologic Skull Base Surgery Panelists Steven Harvey MD Neuro-otologist Fallon
More informationBPPV: pathophysiology, subtypes and therapy Marco Mandalà
BPPV: pathophysiology, subtypes and therapy Marco Mandalà ENT Department, University of Siena, Italy BPPV Most frequent vestibular disease Most common cause of vertigo in humans Lifetime prevalence: 2.4%
More informationDifferential Diagnosis of Dizziness in SCI. Jordan Cabrera, PT, DPT, NCS Jorge Neira, PT, DPT, NCS
Differential Diagnosis of Dizziness in SCI Jordan Cabrera, PT, DPT, NCS Jorge Neira, PT, DPT, NCS Learning Objectives Participant will be able to identify the need to perform a basic oculomotor and vestibular
More informationBPPV and Pitfalls in its Management. Reza Golrokhian Sani MD, Otolaryngologist- Head & Neck Surgeon Otologist & Neurotologist
BPPV and Pitfalls in its Management Reza Golrokhian Sani MD, Otolaryngologist- Head & Neck Surgeon Otologist & Neurotologist Objectives 1-The best methods of diagnosis of BPV 2-How to differentiate between
More informationInternational Journal of Health Sciences and Research ISSN:
International Journal of Health Sciences and Research www.ijhsr.org ISSN: 2249-9571 Original Research Article Comparison of Effectiveness of Epley s Maneuver and Half-Somersault Exercise with Brandt-Daroff
More informationPeripheral vestibular disorders will affect 1 of 13 people in their lifetime
Peripheral vestibular disorders will affect 1 of 13 people in their lifetime 80% of affected persons seek medical consultation Unclear how many of these are for peripheral vs central disorders Generally:
More informationBPPV latest thoughts and the atypical varieties Dr Soumit Dasgupta
BPPV latest thoughts and the atypical varieties Dr Soumit Dasgupta Consultant Audiovestibular Physician and Neurotologist Alder Hey Children s NHS Foundation Trust, Liverpool, UK Claremont Private Hospitals,
More informationInternational Journal of Medical and Exercise Science (Multidisciplinary, Peer Reviewed and Indexed Journal)
ORIGINAL ARTICLE International Journal of Medical and Exercise Science (Multidisciplinary, Peer Reviewed and Indexed Journal) PHYSICAL THERAPY MANAGEMENT IN PATIENTS WITH CERVICOGENIC DIZZINESS-A CASE
More informationBenign Paroxysmal Positional Vertigo (a.k.a.) Diagnosis: Dix-Hallpike Maneuver. Case SH. BPPV nystagmus. MMT ENG course --- BPPV 6/3/2012
Benign Paroxysmal Positional Vertigo Benign Paroxysmal Positional Vertigo (a.k.a.) Timothy C. Hain, MD Departments of Otolaryngology and Physical Therapy Northwestern University, Chicago, IL BPPV BPV (Benign
More informationCan I send this headache patient home? Dr Nicola Giffin Consultant Neurologist Bath, Nov 2017
Can I send this headache patient home? Dr Nicola Giffin Consultant Neurologist Bath, Nov 2017 SAH v benign thunderclap headaches Other pathologies not apparent on CT Severe primary headaches: management
More informationThe Geriatric Patient The EM Perspective. Advice from a neophyte
The Geriatric Patient The EM Perspective Advice from a neophyte Copyright 2017 by Sea Courses Inc. All rights reserved. No part of this document may be reproduced, copied, stored, or transmitted in any
More informationUNDERSTANDING VERTIGO
Backgrounder UNDERSTANDING VERTIGO Vertigo is a false sensation of movement, either of one s self or one s surroundings. It may exist as an isolated symptom or it may be associated with other conditions
More informationBalance Disorder Spectrum
Balance Disorder Spectrum Technical Report: January 2018 Professor Andrew Hugill College of Science and Engineering University of Leicester Leicester, UK andrew.hugill@leicester.ac.uk Professor Peter Rea
More informationwhat is the permanent impact of loss of the vestibular sense? for balance, vision and spatial orientation)
what is the permanent impact of loss of the vestibular sense? for balance, vision and spatial orientation) loss of speed - poor dynamic vision (daily life) - fear to fall and falls loss of automatisation
More informationSteady the dizzy child. Louis M Hofmeyr. (CME, Nov/Dec 2003, Vol 21, No 11.)
Steady the dizzy child Louis M Hofmeyr (CME, Nov/Dec 2003, Vol 21, No 11.) Dizziness in children can be caused by a variety of peripheral and central vestibular disorders. Although less frequent in children
More informationLecture Goals. Dizziness is VERY Common. Dizziness is an imprecise term. Question 1. Diagnostic Categories
Otoneurologist Approach to the Dizzy Patient Timothy C. Hain, MD Clinical Professor Neurology, Otolaryngology, Physical Therapy Northwestern University, Chicago t-hain@northwestern.edu Lecture Goals Describe
More informationDizziness, Vertigo, and Syncope: Assessment and treatment
Dizziness, Vertigo, and Syncope: Assessment and treatment Sally K. Miller, PhD, APRN FNP-BC, AGACNP-BC, AGPCNP-BC Associate Professor University of Nevada Las Vegas School of Nursing Nurse Practitioner
More informationChapter 12 Dizziness and Vertigo
Chapter 12 Dizziness and Vertigo Jonathan S. Olshaker PERSPECTIVE An estimated 7.5 million patients with dizziness are seen each year in ambulatory care settings. It is one of the most common principal
More information