Vestibular Disorder

3.16.1 List important information that should be elicited when taking a history from a dizzy patient.

3.16.2 What are the differences on physical exam between central and peripheral vertigo?

3.16.3 Describe the classic presentation of Meniere’s disease.

3.16.4 Discuss the role of diagnostic studies in the work up of Meniere’s disease including EChoG, vestibular testing and imaging.

3.16.5 What is the suspected pathophysiology of Meniere’s disease? Discuss the role of allergies in Meniere's disease.

Derebery MJ. Allergic and immunologic features of Ménière's disease. Otolaryngol Clin North Am. 2011 Jun;44(3):655-66, ix. Epub 2011 May 4. PMID:21621052

3.16.6 Provide us with an algorithm for the treatment of Meniere’s disease.

3.16.7 You and your friend are SCUBA diving. During descent, he has difficulty equalizing pressure in his ears and becomes acutely dizzy. What are you worried about and how would you treat him?

3.16.8 You suspect BPPV in a dizzy patient. Discuss the work up and treatment of this disorder. What will you tell your patient about recurrence? Should postural restrictions be recommended after canalith repositing?

De Stefano A, et al. Are postural restrictions necessary for management of posterior canal benign paroxysmal positional vertigo? Ann Otol Rhinol Laryngol. 2011 Jul;120(7):460-4. PMID:21859055

3.16.9 Discuss the role of migraines as a cause of vertigo.

Cha YH. Migraine-associated vertigo: diagnosis and treatment. Semin Neurol. 2010 Apr;30(2):167-74. Epub 2010 Mar 29. PMID:20352586

3.16.10 What are the symptoms and etiology of Wallenberg’s syndrome?

3.16.11 When is vertigo an emergency?

3.16.12 What are the indications for vestibular rehabilitation therapy? What does this therapy entail?

3.16.13 What are the clinical manifestations of and diagnostic work up for superior semicircular canal dehiscence syndrome? What treatment is available for severely symptomatic patients? Discuss potential risks and benefits of surgical treatment.

Minor LB. Clinical manifestations of superior semicircular canal dehiscence. Laryngoscope. 2005 Oct;115(10):1717-27. PMID:16222184