Migraine, tension headache, cluster headache, chronic paroxysmal hemicrania
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- Gerald Kelley
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3 Primary headaches Migraine, tension headache, cluster headache, chronic paroxysmal hemicrania Secondary headaches Headaches due to neurological reasons: Posttraumatic, vascular, infectious headaches, metabolic headaches Otolaryngological and ophthalmological headaches Neuralgias
4 Outer and middle ear diseases Diseases of nasal and paranasal sinuses Nasopharyngeal diseases
5 13. Complications of purulent acute and chronic otitis media. 34. Complications of sinusitis. 35. Benign and malignant tumors of the paranasal sinuses. Principles of treatment. 38. Diseases of the nasopharynx. Symptoms adenoid hyperplasia.
6 Viral infection of the upper airways; Inflammation of nasal sinuses: (acute and chronic); Benign and malignant tumors of nasal sinuses; Cervical: cervical vertebra disorders, spondylosis, myalgia; Complications of otitis and sinusitis: mastoiditis, meningitis, brain abscess, inflammation of the petrous pyramid; Neuralgias; Pain of temporomandibular joint. Minimum criteria for the ENT exam - essential ENT knowledge for a physician
7 Temporomandibular joint disorders (Costen syndrome): Unilateral headache, earache, chewing problems
8 Temporomandibular joint arthritis, neuralgia Differentialdiagnostic problems: Headache (sinusitis? Neurological disorders?) Facial pain (sinusitis?) Earache (otitis?) Tinnitus (middle and inner ear disorders?) Trismus (peritonsillar abscess?) Neck pain, torticollis (neck phlegmone, or abscess?) Otalgia irradiata (Larynx? Hypopharynx?)
9 Mastoiditis Subperiosteal abscess Labyrinthitis Peripheral facial palsy Thrombosis of sigmoideal sinus Petrositis Meningitis Brain abscess
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11 Extracranial Intratemporal Acute mastoiditis; Zygomaticitis; Petrositis; Facial nerve palsy; Labyrinthitis; Extratemporal Abscess: subperiosteal, preauricular, suboccipital, Bezold's abscess; Intracranial Extradural abscess; Sinus phlebitis - sinus thrombosis; Subdural abscess; Meningitis, encephalitis; Brain abscess; General: sepsis. Minimum criteria for the ENT exam - essential ENT knowledge for a physician
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14 Frontal sinusitis forehead; Maxillary sinusitis face; Ethmoidal sinusitis periorbitally, between the eyes; Sphenoid sinusitis crown of the head, referring to the occipital area; All forms of sinusitis can cause diffuse headache. Minimum criteria for the ENT exam - essential ENT knowledge for a physician
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16 Orbital cellulitis Orbital abscess Osteomyelitis Thrombophlebitis of cavernosal sinus Meningitis Brain-abscess
17 Extracranial complications Periorbital cellulitis; Subperiosteal abscess; Orbital phlegmone / abscess; Osteomyelitis; Sepsis; Intracranial complications Meningitis; Epi/subdural or brain abscess, encephalitis; Cavernous sinus thrombosis. Minimum criteria for the ENT exam - essential ENT knowledge for a physician
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20 7. Anatomy and physiology of the vestibular system. Harmonic and disharmonic vestibular syndrome. 8. Fundamental examination tools of otoneurology. 20. Ménière s syndrome and Ménière s disease. Therapeutic options. 21. Differential diagnosis of BPPV, vestibular neuronitis and Ménière s disease.
21 Labyrinth Vestibular nerve Vestibular nuclei Vestibular pathways Vestibulocerebellar Vestibulospinal Vestibuloocular Vestibuloreticular Cortical, hippocampal pathways
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24 Ear drum examination Hearing tests Pure tone audiometry Vestibular system tests Statokinetic (vestibulospinal) Spontaneous nystagmus (vestibulo-ocular reflex tests) Positional nystagmus tests Head impulse test Vestibular provocation tests: Optokinetic tests Caloric irrigation tests Rotational tests
25 Previous diseases: heart diseases, blood-pressure, renal failures, drugs, ear diseases, neurological diseases, neck vertebra problems Types of vertigo: rotatory vertigo, unsteadiness, lightheadedness, imbalance Length of vertigo: seconds, minutes, hours, days, constant dizziness Single recurrent attacks Concomitant symptoms: hearing loss, tinnitus, discharge from ear, nausea, vomitus, loss of consciousness, headache
26 Romberg s test Past pointing tests Blind walking test
27 Horisontal Vertical Rotatory Horisontorotatory Verticorotatory Retraction
28 Alapja: Ép végkészülék esetén fejmozdítás után a látótér stabil. Csökkent vestibularis működés esetén a látótér stabilizálásához átmeneti refixációs szemmozgás szükséges. Vizsgálat: Egy pontra fixáltatjuk a beteget, és hirtelen elfordítjuk a fejét. Normális esetben nystagmus nincs, kóros esetben rövid refixációs nystagmus.
29 Torsional (Causse)-latero-retroflexion of the neck Positional and positioning nystagmus Dix-Hallpike manouvre
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31 Patient history: Type of vertigo (sensation of spinning or falling); Vegetative symptoms, nausea, vomiting. Examination: deviation, tilting; spontaneous nystagmus and nystagmus provoked by head movements. Minimum criteria for the ENT exam - essential ENT knowledge for a physician
32 More than 24 hours long severe vertigo with nausea, vomitus, motion intolerance, balance disorder and nystagmus. 1. Vestibular neuronitis 2. Stroke Differential diagnosis: head impulse test in the ED
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36 Vestibular neurectomy III. Stadium Intratympanal gentamycin Saccotomy Vasoactive drugs, intratympanal dexametasone II. Stadium Parenteral vasoactive drugs Betahistine, salt-free diet, saluretics I. Stadium
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38 Head Diseases Lenth of attacks position Hearing loss influence Ménière s disease Hours NO YES Vestibular neuronitis Days NO NO BPPV Seconds, but YES NO recurrent
39 14. Differentiation of central and peripheral facial nerve palsy. Causes of peripheral facial nerve palsy, differential diagnosis.
40 No wrinkles on face, on forehead No eye-closure, Bell s phenomenon No movements on face Nasolabial assymmetry Lacrimation or dry eye Hyperacusia, Tasting disorder
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43 Otoscopy Audiometry, tympanometry, stapedial reflex Imaging methods (Schüller, CT, MR) Parotid gland palpation (ultrasonography) Blood tests (diabetes!), blood pressure Topical diagnosis n. petrosus- lacrimation -Shirmer teszt n. stapedius-hyperacusis- stapedial reflex chorda tympani tasting disorders- gustometria Electrodiagnostic tests
44 Bell s palsy; Herpes zoster oticus; Other viral or bacterial infections (HSV, EBV, Lyme); Acute and chronic middle ear diseases (acute and chronic middle ear infections, cholesteatoma, rarely tumors); Tumors of the pontocerebellar angle, vestibular schwannoma; Cranial traumas (pyramid bone fractures), extratemporal traumas; Malignant tumors of parotid gland. Minimum criteria for the ENT exam - essential ENT knowledge for a physician
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7. Anatomy and physiology of the vestibular system. Harmonic and disharmonic vestibular syndrome.
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Minimum criteria for the ENT exam - essential ENT knowledge for a physician
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CITY & HACKNEY PATHFINDER CLINICAL COMMISSIONING GROUP. Vertigo. (1) Vertigo. (4) Provisional Diagnosis. (5) Investigations. lasting days or weeks
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Vertigo. Definition Important history questions Examination Common vertigo cases and management Summary
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