89 results
Mastoiditis: Pathogenesis and clinical findings

Acute or Chronic Otitis Media -> 
Stage 1: Hyperemeia of the mastoid
Erythema, fluctuant, tender ... vomiting, dizziness, vertigo ... , nystagmus • ... pathophysiology #signs #symptoms
HINTS Exam - Bidirectional Nystagmus 

In a patient with vertigo symptoms, this finding is worrisome for
Bidirectional Nystagmus ... a patient with vertigo ... symptoms, this ... CENTRAL cause of vertigo ... Bidirectional #Nystagmus
HINTS Exam - Unidirectional Nystagmus - Left-beating

In a patient with vertigo symptoms, this finding is reassuring
Unidirectional Nystagmus ... a patient with vertigo ... symptoms, this ... PERIPHERAL cause of vertigo ... Unidirectional #Nystagmus
Classic Findings During Hallpike Test in Posterior Canal Benign Paroxysmal Positional Vertigo (BPPV)
 • Latency (delay
Latency (delay in nystagmus ... symptoms in head-hanging ... and torsional nystagmus ... and nystagmus escalates ... 30 seconds • Nystagmus
Causes of Dizziness - Vertigo - Differential Diagnosis Algorithm
True Vertigo - Illusion of Rotary Movement
Peripheral Vestibular
of Dizziness - Vertigo ... vomiting, auditory symptoms ... unidirectonal nystagmus ... Imbalance, neurologic symptoms ... bidirectional nystagmus
Diagnostic Algorithm for Dizziness and Vertigo
Peripheral Vertigo:
 • Attacks: Sudden, severe, can last anywhere from seconds
Peripheral Vertigo ... minutes to days • Nystagmus ... vascular causes • Nystagmus ... No auditory symptoms ... Long symptom-free
The HINTS Exam - Differentiating Central vs Peripheral Vertigo

Head Impulse Test
Nystagmus
Test of Skew

Animation by Dr. Y.
vs Peripheral Vertigo ... Impulse Test Nystagmus ... PhysicalExam #Testing #Vertigo
Characteristics of Peripheral and Central Vertigo
PERIPHERAL VERTIGO
 • Onset: Sudden
 • Intensity: Severe initially, often decreasing
Peripheral and Central Vertigo ... PERIPHERAL VERTIGO ... vestibular neuritis • Nystagmus ... circulation TIA • Nystagmus ... findings #signs #symptoms
Labyrinthitis 
Vestibular neuritis + unilateral hearing loss = Labyrinthitis 
1) Vertigo (severe) 
2) Gait instability 
3)
Labyrinthitis 1) Vertigo ... vestibular CN VIII • Nystagmus ... Labyrinthitis #Diagnosis #Symptoms
Differentiating Benign Paroxysmal Positional Vertigo (BPPV) From Vestibular Neuritis-Labyrinthitis
BENIGN PAROXYSMAL POSITIONAL VERTIGO
 • Age: More common
Paroxysmal Positional Vertigo ... • Frequency of symptoms ... and torsional nystagmus ... reproduction of vertigo ... symptoms • Head