ENT: Vertigo: Free MSRA Podcast

⚕️ FREE MSRA PODCAST – Vertigo🎧 A clear, high-yield breakdown of this false spinning sensation from the vestibular system – perfect for exam prep and real-life clinical scenarios.🧠 Key Learning Points📌 Definition• Vertigo is a false sensation of spinning or movement, despite being still.• It is a specific type of dizziness, often accompanied by balance issues.• Caused by a mismatch between signals from the inner ear, vision, and proprioception.📌 Causes & Risk Factors• Peripheral causes:– BPPV (Benign Paroxysmal Positional Vertigo)– Vestibular neuritis– Ménière’s disease– Labyrinthitis– Ototoxicity– Herpes zoster oticus• Central causes:– Stroke or TIA (especially posterior circulation)– Vestibular migraine– Multiple sclerosis– Acoustic neuroma– Alcohol intoxication• Risk factors:– Age >60, prior ear infections, head trauma, migraine, ototoxic meds, cardiovascular disease🧠 Mnemonic: “V.I.N.O.” – Vestibular neuritis, Infection, Neuroma, Otoliths (BPPV)📌 Pathophysiology• Caused by dysfunction in the vestibular system (inner ear or brainstem pathways).• Leads to conflicting input to the brain about head position and movement.• Brain interprets this as rotation – producing vertigo.📌 Symptoms• Rotational spinning sensation• Often worsened by head movements• Associated symptoms:– Nausea, vomiting– Imbalance, ataxia– Nystagmus (jerky eye movements)– Ear symptoms: tinnitus, hearing loss (if peripheral cause)• In older patients, may present as unsteadiness or general dizziness📌 Differential Diagnosis• Presyncope – cardiovascular or postural causes• Disequilibrium – peripheral neuropathy, visual impairment• Psychogenic dizziness – anxiety, panic attacks• Neurological causes – cerebellar stroke, Parkinson’s, MS📌 Diagnosis• Clinical diagnosis in most peripheral cases• Key history features:– Triggered by movement?– Associated neurological signs?• Examination:– Nystagmus pattern– Dix-Hallpike manoeuvre (for BPPV)– Romberg’s, Head Impulse Test, Unterberger's test• Imaging (MRI/CT) only if:– A central cause suspected– New hearing loss, neurological red flags, or atypical presentation📌 Management• Cause-specific treatment:– BPPV: Epley manoeuvre– Vestibular neuritis: Corticosteroids (early), then vestibular rehab– Ménière’s: Low-salt diet, diuretics, ENT referral• Symptom relief:– Prochlorperazine or antihistamines short-term only– STOP 48 hours before specialist assessment• Rehabilitation:– Vestibular rehabilitation exercises (e.g. Cawthorne-Cooksey)– Shown effective for chronic or residual dizziness• Referral criteria:– Sudden hearing loss– Severe persistent vertigo– Neurological signs (e.g. ataxia, diplopia)– Unclear diagnosis📌 Complications• Falls and injuries (especially in older adults)• Reduced mobility, social isolation• Anxiety, panic attacks, depression• Chronic disability if not diagnosed and managed correctly📌 Prognosis• Most peripheral causes (e.g. BPPV) have a good prognosis with appropriate treatment• Central causes can be more serious, and prognosis depends on the underlying condition• Chronic symptoms often improve with rehabilitation📎 More MSRA Resources for Vertigo📝 Revision Notes:https://www.passthemsra.com/topic/vertigo-revision-notes/🧠 Flashcards:https://www.passthemsra.com/topic/vertigo-flashcards/💬 Accordion Q&A Notes:https://www.passthemsra.com/topic/vertigo-accordion-qa-notes/🚀 Rapid Quiz:https://www.passthemsra.com/topic/vertigo-rapid-quiz/🎓 Full Course:https://www.passthemsra.com/courses/ent-for-the-msra/🔗 All resources are part of the ENT for the MSRA course:https://www.passthemsra.com – explore revision guides, quizzes, flashcards, + more.#MSRA #MSRARevisionNotes #MSRATextbook #MSRAQuiz #MSRAQuestionBank #MSRAFlashcards #MSRAQANotes #MSRAAccordions #MultiSpecialityRecruitmentAssessment #MSRAOnlineRevision #MSRARevisionWebsite #ENT #Vertigo