University:
Western Sydney University
Course:
MEDI 2003 | Clinical Sciences 2
Academic year:

2024
Views:

372

Pages:

3
Author:

Mariam A.

Differentiating Vestibular from Non-Vestibular Causes of Dizziness Dizziness is a common clinical symptom with a multitude of potential causes, broadly categorized into vestibular and non-vestibular origins. Understanding the differences between these categories is crucial for accurate diagnosis and effective management. Vestibular Causes of Dizziness Vestibular dizziness arises from dysfunction within the vestibular system, which includes the inner ear structures and their central nervous system connections. 1. Benign Paroxysmal Positional Vertigo (BPPV): o o o o Etiology: Displacement of otoliths within the semicircular canals. Symptoms: Sudden, brief episodes of vertigo triggered by changes in head position. Patients describe a spinning sensation lasting seconds to minutes. Diagnosis: Positive Dix-Hallpike maneuver. Treatment: Canalith repositioning maneuvers like the Epley maneuver. 2. Meniere’s Disease: o o o o Etiology: Endolymphatic hydrops, increased fluid pressure in the inner ear. Symptoms: Recurrent episodes of vertigo lasting minutes to hours, fluctuating hearing loss, tinnitus, and aural fullness. Diagnosis: Clinical evaluation, audiometry, and electrocochleography. Treatment: Dietary modifications, diuretics, vestibular suppressants, and in severe cases, surgery. 3. Vestibular Neuritis: o o o o Etiology: Inflammation of the vestibular nerve, often viral. Symptoms: Acute onset of prolonged vertigo, nausea, and imbalance without hearing loss. Diagnosis: Clinical presentation, head impulse test, and exclusion of central causes. Treatment: Corticosteroids, vestibular rehabilitation exercises. 4. Labyrinthitis: o o o Etiology: Inflammation of both the vestibular and cochlear nerves. Symptoms: Vertigo, nausea, vomiting, and unilateral hearing loss. Diagnosis: Clinical assessment and audiometry. o Treatment: Similar to vestibular neuritis with added focus on hearing restoration. Non-Vestibular Causes of Dizziness Non-vestibular dizziness encompasses a wide range of conditions affecting systems other than the vestibular apparatus. 1. Cardiovascular Causes: o Orthostatic Hypotension: Dizziness upon standing due to a sudden drop in blood pressure.     o Etiology: Dehydration, medications, autonomic dysfunction. Symptoms: Lightheadedness, weakness, and syncope. Diagnosis: Measuring blood pressure changes upon standing. Treatment: Hydration, compression stockings, medication adjustment. Arrhythmias: Irregular heart rhythms leading to inadequate cerebral perfusion.    Etiology: Atrial fibrillation, ventricular tachycardia. Symptoms: Palpitations, chest pain, and fainting. Diagnosis: Electrocardiogram (ECG), Holter monitoring.  Treatment: Antiarrhythmic medications, pacemaker insertion. 2. Neurological Causes: o Migraine-Associated Vertigo:     o Etiology: Migraine headaches with vestibular symptoms. Symptoms: Episodic dizziness, headache, photophobia, phonophobia. Diagnosis: Clinical criteria and exclusion of other causes. Treatment: Migraine prophylaxis and acute treatments. Multiple Sclerosis (MS):    Etiology: Demyelination within the central nervous system. Symptoms: Dizziness, vertigo, and other neurological deficits. Diagnosis: MRI, lumbar puncture, evoked potentials. Treatment: Disease-modifying therapies, symptomatic management