Disorders of vestibular system ppt by Dr Manas Powerpoint Presentation

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Disorders of vestibular system ppt by Dr Manas

by: Dr Manas Ranjan Rout

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Dr Manas Disorders of Vestibular System 1

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Disorders of Vestibular system mainly presents with Vertigo. 2

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Non-pathological Vertigo of height Vertigo after rotation and motion sickness Vertigo due to sudden change of floor texture Pathological Central causes (CNS involvement) Peripheral causes (Vestibular end organ and their first order neurons) Causes of Vertigo 3

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Central causes Vertebrobasilar insufficiency Posterior inferior cerebellar artery syndrome Basilar migraine Cerebellar disease Multiple sclerosis Epilepsy Cervical vertigo Tumor brain stem Due to visual disorder (diplopia, sudden blindness) Vertigo without deafness (Vestibular neuronitis, BPPV, Ototoxicity) Vertigo with deafness (Meniere’s disease, Labyrinthitis, Acoustic neuroma, perilymph fistula, Herpes zoster otiticus) Pathological causes of Vertigo Peripheral causes 4

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Meniere’s disease (Endolymphatic hydrops) Characterized by vertigo tinnitus fluctuating hearing loss fullness of ear. Vertigo is sudden and last for few minute to 24 hrs 5

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Vertigo when head is placed in a certain critical position. No hearing loss and other neurological symptoms Disorder in posterior semicircular canal Otoconial debris (Calcium carbonate crystals) Hallpike manoeuvre establishes the diagnosis Condition can be treated by Epley’s manoeuvre Benign paroxismal positional vertigo (BPPV) 6

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Five positions Head turn 45°, made to lie down in head hanging position Head turn till affected ear is up Pt made to lateral recumbent position Pt brought to sitting position head still turn to unaffected side Head now turn forward and chin brought down 20°. Epley’s manoeuvre 8

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Severe vertigo of sudden onset No cochlear symptom Attack from few days to 2-3 weeks. Self limiting disease Vestibular neuronitis 9

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Circumscribed labyrinthitis Serous labyrinthitis Purulent labyrinthitis Labyrinthitis 10

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Aminoglycisides Antihypertensives Labyrinthine sedetives Oestrogen preparations Diuretics Nalidixic acid, Metronidazole Antimalarial drugs Vestibulotoxic drugs 11

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Head injury Perilymph fistula Syphilis Acoustic neuroma Others 12

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Common cause of central vertigo in pt more then 50 years Common cause is atherosclerosis and ischemia. History of diplopia, drop attack, hemiparesis dysphagia. Vetebrobasilar insufficiency 13

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Also called Posterior inferior cerebellar artery syndrome Due to thrombosis of posterior inferior cerebellar artery Vertigo, ataxia, diplopia, dysphagia, hoarseness of voice Sensory loss on ipsilateral side of face and contra lateral side of body. Wallenberg's syndrome 14

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Basilar migrain Cerebellar disease Multiple sclerosis Tumor of brainstem and floor of IV th ventricle Epilepsy Cervical vertigo Other central vestibular disorders 15

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Ocular vertigo( high error of refraction, acute extra ocular muscle paresis) Psychogenic vertigo Other causes of Vertigo 16

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THANK YOU 17