vertigo and peripheral vestibular disorders
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VERTIGO
B.BaratiOtorhinolaryngologist
Otologist, Neuro-otologistAssociate professor
Shahid Beheshti Medical University
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Differential
• 40% Peripheral vestibular dysfunction• 10% Central brainstem vestibular
lesion • 25% Presyncope or disequilibrium• 15% Psychiatric disorder• 10% Unknown cause
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Peripheral Vestibular System
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Peripheral vs Central Vertigo
• Onset• Severity• Positional• Intrmitant• Otologic findings• Neurologic findings• Nystagmus
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Nystagmus
Fa s t p h a s eToward dominant earC O W SH o r i z o n t a l , To r s i o n a lF i x a t i o n s u p p r e s s i o n
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Peripheral vs Central Vertigo
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Vestibular dysfunction...Peripheral causes
canalithiasis (BPPV) -- 50% vestibular neuronitis (labyrinthitis) --
25% Meniere’s disease -- 10% trauma drugs (aminoglycosides)
Central causes vascular (vertebrobasilar insufficiency)
-- 50% demyelinating (multiple sclerosis) drugs (anticonvulsants, alcohol,
hypnotics)
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Benign paroxysmal positional vertigo
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Dix-Hallpike
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Dix-Hallpike
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Other Tx
• Medical • Surgical
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Meniere’s Disease
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