Vertigo2026/2/26
2026/2/26 1 Vertigo
VertigoDisturbanceof thesenseof equilibriumandmovements.Feels surrounding / onself rotatingDefined as‘subjective sense of imbalanceor“thehallucinationof movement"Variesmildimbalanceofdizzinesstosevereincapacitating vertigo: c/f - syncope (fainting)2026/2/26
2026/2/26 2 Vertigo • Disturbance of the sense of equilibrium and movements • Feels surrounding / onself rotating • Defined as ‘subjective sense of imbalance’ or ‘the hallucination of movement’ • Varies mild imbalance of dizziness to severe incapacitating vertigo • c/f – syncope (fainting)
Causes of vertigoPhysiological:HeightsSpinningmovementsFloortextureFunctionalPathologicalcausesintheear-labyrinthitis,Meniere'ssyndrome-MD,BPPV,vestibularneuronitis,VS,trauma,PLfistula,CSOMvascular,motionsickness,ototoxicitycausesoutsidetheear-CVS -hypertension, hypotension,BBB,AR,MR,arrhythmiasCNS-vertebrobasilary syndrome,MStumour,abscess,migraine,epilepsy,ICP,head injurymetabolic-DM,hypoglycaemia,hypothyroidismanaemia,eye-diplopioa,RE,glaucomacervicalspondylosis2026/2/26
2026/2/26 3 Causes of vertigo • Physiological : Heights Spinning movements Floor texture • Functional • Pathological causes in the ear – labyrinthitis,Meniere’s syndrome – MD, BPPV, vestibular neuronitis,VS, trauma, PL fistula, CSOM vascular,motion sickness, ototoxicity causes outside the ear – CVS – hypertension, hypotension,BBB, AR,MR,arrhythmias CNS – vertebrobasilary syndrome,MS, tumour,abscess,migraine, epilepsy, ICP,head injury metabolic – DM,hypoglycaemia,hypothyroidism anaemia,eye – diplopioa, RE, glaucoma cervical spondylosis
Approach to a case of vertigoHistoryHistoryHistoryExaminationInvestigationsTreatment2026/2/26
2026/2/26 4 Approach to a case of vertigo • History • History • History • Examination • Investigations • Treatment
History taking in VertigoDOPEA (duration,onset,progress,effect,associated symptomsIs it a true vertigo?First attack, frequencyPrecipitatingfactorsTraumainfectionPMH,medication,alcohol52026/2/26
2026/2/26 5 History taking in Vertigo • DOPEA (duration,onset,progress, effect,associated symptoms) • Is it a true vertigo ? • First attack, frequency • Precipitating factors • Trauma,infection • PMH,medication,alcohol