with Correct Answers
Dix hallpike: turn pt's head to a ___ degree angle and bring them down for about ___
seconds - Answer-45 degree
45 seconds
In Dix hallpike, if nystagmus is present, it should appear within___ and should beat ___
for BPPV but if it beats ___ - Answer-appear within 2-15 sec
beat opposite to the ear being evaluated
If beats in same direction as test ear, could be central
Dix hallpike must be repeated on ___ side if hallpike is abnormal on ___ side - Answer-
both sides if abnormal on either side
we do ___ calorics then ___ (temperature - Answer-Right cool 24 degrees
left cool
if right cool and left cool are both weak, less than ___, immediately conduct ice water
caloric testing to see if you can evoke a stronger response - Answer-6-8 degrees
For a nystagma to be significant, there must be several and it must be at least ___
degrees - Answer-4 degrees
Vestibular Migrane:
basilar migraines fulfill the criteria for migraine with aura, but two or more of the
following aura symptoms occur - Answer-Vertigo
Tinnitus
Decreased hearing
Ataxia
Visual symptoms in both hemifields of both eyes
Dysarthria
Double Vision
Bilateral Paresthesias
Bilateral Paresis
Decreased Level of Consciousness
In patients with vestibular migraine dizziness may have been present for:
and symptoms may last for: - Answer-present for weeks, months, or years
symptoms may last for a few minutes or be continuous for several weeks
Long history of frequent motion sickness
Otologic causes of dizziness account for __% of all dizziness - Answer-50% (40-50%)
, Causes of otologic dizziness and percent of time it is the cause - Answer-BPPV (50%)
Meniere's (18%)
Vestibular Neuritis and Labyrinthitis (14%)
Perilymph Fistula (rare)
Bilateral vestibular loss (rate)
Acoustic neuroma (rare)
Other types of dizziness - Answer--Central or neurologic (brain related) (5%) or (10-
30%) (Stroke, migraine, seisure, degeneration/malformation)
-Medical (5-10%) or (10-30%) (low BP, medication)
Psychological (anxiety)
-Unknown or psychiatriac/unknown (25%) or 15-50%)
Dizziness is the primary complaint in ___% all primary care visits - Answer-2.5%
= 8 million/year visits
vertigo is a feeling of: - Answer--feeling of spinning or whirling when you are not actually
moving
-feeling that you or your surroundings are moving when they are actually still
What is oscillopsia? - Answer-visual disturbance in which objects in the visual field
appear to oscillate
what is ataxia? - Answer-the loss of full control of bodily movements.
Vertigo duration: BPPV, TIA, Meniere's, Vestibular Neuronitis, Ototoxins - Answer-
BPPV-seconds, TIA-minutes, Menieres-hours, Vestibular Neuronitis-Days, Ototoxins-
years
Canals register ___ - Answer-head velocity
Otoliths register ___ - Answer-linear acceleration
together the canals and otoliths provide two central reflexes: - Answer-VOR (Vestibulo-
Occular Reflex)
VSR (Vestibulo-Spinal Reflex)
Tullio Phenomenon (dizziness induced by sound) occurs mainly in five ear conditions
which are: - Answer-superior canal dehiscence
perilymph fistula
Meniere's Syndrome
Post Fenestration surgery
Vestibulofibrosis