Answers:
The duration of vertigo is typically --- in Meniere disease, --- in BPPV and --- in a TIA.
A) Hours, Minutes, Seconds
B)Hours, Seconds, MinutesC)Minutes, Hours, Seconds
D) Minutes, Seconds, Hours
E) Seconds, Minutes, Hours
F) Seconds, Hours, Minutes
MC Questions:
Which of the following in a PE finding that may indicate the presence of a perilymphatic fistula?
A) Hennebert Sign
B) Positive Dix-Hall-Pike Manuever
C) Positive Fukuda Test
D) Hyperkinetic Optokinetic Afternystagmus
E) None of the above
F) All of the above
A) Hours, Minutes, Seconds
B)Hours, Seconds, MinutesC)Minutes, Hours, Seconds
D) Minutes, Seconds, Hours
E) Seconds, Minutes, Hours
F) Seconds, Hours, Minutes
Meniere disease typically produces a vertigo lasting hours 1-24 hours although it can be shorter. A TIA can last for several hours, however it is more common for vertigo to last 2-20 minutes. BPPV is typically a short and intense vertigo lasting less than a minute.
What is the Tullio Phenomenon?
Tullio phenomenon, sound-induced vertigo, dizziness, nausea or eye movement was first described in 1929 by the Italian biologist Prof. Pietro Tullio. (1881–1941). During his experiments on pigeons, Tullio discovered that by drilling tiny holes in the semicircular canals of his subjects, he could subsequently cause them balance problems when exposed to sound.
The cause is usually a fistula in the middle or inner ear, allowing abnormal sound-synchronized pressure changes in the balance organs Such an opening may be caused by a barotrauma (e.g. incurred when diving or flying), or may be a side effect of fenestration surgery, syphilis or Lyme disease. Patients with this disorder may also experience vertigo, imbalance and eye movement set off by changes in pressure, e.g. when nose-blowing, swallowing or when lifting heavy objects.
Tullio phenomenon is also one of the common symptoms of superior canal dehiscence syndrome (SCDS), first diagnosed in 1998 by Dr. Lloyd B. Minor, The Johns Hopkins University, Baltimore, USA.
-Answer source: Wikipedia.
The cause is usually a fistula in the middle or inner ear, allowing abnormal sound-synchronized pressure changes in the balance organs Such an opening may be caused by a barotrauma (e.g. incurred when diving or flying), or may be a side effect of fenestration surgery, syphilis or Lyme disease. Patients with this disorder may also experience vertigo, imbalance and eye movement set off by changes in pressure, e.g. when nose-blowing, swallowing or when lifting heavy objects.
Tullio phenomenon is also one of the common symptoms of superior canal dehiscence syndrome (SCDS), first diagnosed in 1998 by Dr. Lloyd B. Minor, The Johns Hopkins University, Baltimore, USA.
-Answer source: Wikipedia.
Which of the following in a PE finding that may indicate the presence of a perilymphatic fistula?
A) Hennebert Sign
B) Positive Dix-Hall-Pike Manuever
C) Positive Fukuda Test
D) Hyperkinetic Optokinetic Afternystagmus
E) None of the above
F) All of the above
Free Response Question:
In what direction does nystagmus beat when cold caloric testing is performed? In warm caloric testing?
Quick Facts:
Vestibular Evoked Myogenic Potentials
-Short latency electromyograms evoked by acoustic stimuli.
-Origin is saccule.
-Response pathway is saccule, inf vestibular nerve, lateral vestibular nucleus, lateral vestibuolspinal tract, SCM.
-Main interest is amplitude of wave and threshold asymmetries btwn R and L side.
-When ratio of L and T ear exceeds 36% = likely saccular hydrops = "augmented VEMP".
-Absent in 54% of meniere
-Absent in vestibular schwannoma.
-Absent in vestibular neuronitis.
-Superior cannal dehiscence syndrome causes lowered VEMP.
-Absent in otosclerosis.
-Short latency electromyograms evoked by acoustic stimuli.
-Origin is saccule.
-Response pathway is saccule, inf vestibular nerve, lateral vestibular nucleus, lateral vestibuolspinal tract, SCM.
-Main interest is amplitude of wave and threshold asymmetries btwn R and L side.
-When ratio of L and T ear exceeds 36% = likely saccular hydrops = "augmented VEMP".
-Absent in 54% of meniere
-Absent in vestibular schwannoma.
-Absent in vestibular neuronitis.
-Superior cannal dehiscence syndrome causes lowered VEMP.
-Absent in otosclerosis.
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