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20 Cards in this Set
- Front
- Back
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What is Romberg's sign?
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hands out in front with eyes closed, and marking findings
- Tests proprioceptive input in PNS and CNS |
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What is the 3rd most common outpateint compalin?
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dizziness
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Define vertigo
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‐ illusion of movement
‐ vestibular (often a solitary symptom) (semicircular canals/otoliths) ‐ neurologic (accompanied by additional symptoms sweating and nausea), sometimes has hearing impairment or tinnitus |
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Define dysequilibirium
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‐ nonvertiginous altered static or dynamic
balance sensory ‐ worse in dark (Romberg sign) motor ‐ central or peripheral (no Romberg sign)- arthiritis - |
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define presyncope
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impending loss of consciousness (orthostasis, arrythmia, HVT) aggravated by temperature, prolonged standing, large meal
- caused by arrythmia, hypotension vasovagal exess, pulmonary emboli, drugs |
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What are the differences with peripheral vs central brain problems symptoms
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Peripheral- no neuro symtoms
Central- +/- vertigo, no/rare hearing loss, no tinnitus, neuro symptoms |
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What is the most common cause of recurrent vertigo?
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benign positional vertigo- can be caused by idiopathic, trauma, infection
Thought to be due to debris floating in endolymph of any of the semicircular canals (posterior 90% time) |
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How can benign postional vertigo be diagnosed?
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Can be made on clinical grounds in a patient with positional
vertigo. Confirmed by Dix‐Hallpike position testing |
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How is BPV treated?
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Positional exercises often helpful
Medications Vestibular suppressants – meclizine, scopolamine, valium Antiemetics – Phenergan, Compazine, etc. Anxiolytics Physical therapy – vestibular rehabilitation (balance therapy |
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What is vestibular neuronitis?
Characterized by? |
– Spontaneous attack of vertigo that does not
involve hearing loss or tinnitus and resolves spontaneously. – Characterized by vertigo, nausea, and vomiting of acute onset, typically lasting up to 2 wk. – Not characteristically positional |
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What is meniere's disease and how is it diagnosed?
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type of peripheral vestibular disorder
- Thought due to an increase in the volume of labyrinthine endolymph because of poor absorption (endolymphatic hydrops) |
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What are symptoms meniere's disease?
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Recurrent episodes of spontaneous vertigo
– lasting more than 20 minutes, typically hours, but less than 24 – dysequilibrium could last several days Audiometrically documented hearing loss Tinnitus Aural fullness |
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What drugs induce peripheral vestibular disorders?
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Alcohol
Salicylates Anti‐epileptics Quinine & Quinidine Cis‐Platinum Aminoglycosides Furosemide |
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Name 2 central disorders that are developmental disorders
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1. chiari malformation- malformation in the foramen magnum usually squeezes the spinal cord and could cause spinal cord related problems
2. dandy- walker malformation |
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What medications could cause central disorders?
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DPH (dilantin), anticonvulsants, 5-FU, Li, Mtx
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What is friedreich's ataxia?
Chromosome? Diagnosis? |
Autosomal recessive disorder due to a mutation on chromosome 9.
- 100% has to have... 1. <20 y/o 2. gait ataxia 3. progression of ataxia all 4 limbs 4. dysarthria 5. impaired position/ vibratory sense in legs 6. muscle weakness 7. absent tendon reflexes in legs |
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What are secondary features of friederich's ataxia?
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1. extensor plantar rsponses
2. pes cavus 3. scoliosis 4. cardiomyopathy 5. -/+ optic artrophy, nystagmus |
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What is the prognosis and treatment of freidreich ataxia?
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– No treatment available.
– Neurologic dysfunction typically results in the inability to walk unaided within 5 years after onset of symptoms and in bedridden state within 10‐20 years. – Mean age of death – 35 years |
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What is ataxia telangiectasia?
Chromosome>? |
Autosomal recessive – chromosome 11 mutation
Progressive pancerebellar degeneration involving nystagmus, dysarthria, and gait, limb and trunk ataxia which begins in infancy (<4yr. of age). |
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Characterized by progessive ataxia, oculocutaneous telangiectasia, and
immunologic deficiency oculocutaneous telangiectasia appears during which years? |
ataxia- telangiectasia
teen years |
