Vertigo

Definition: Illusion of movement.

ΔΔx.

  1. Meniere's disease
  2. benign positional vertigo
  3. epidemic labyrinthitis
  4. cerebellopointine lesion (acoustic neuroma, meningioma, epidermoids)
  5. drugs (esp. aminoglycosides)

Examination

Hallpike manoeuvre:
  1. sit patient up, and explain
  2. grasp his head
  3. lie him down
  4. turn his head to one side
  5. if positive, you will see nystagmus towards the affected side.
Repeat for the other side. Positive=benign positional vertigo. Other cranial nerves arising from cerebellopontine angle should also be tested: V, VII. There may be mild ipsilateral UMN signs.

Treatment

Vestibular sedative: e.g., cinnarizine or prochlorperazine.