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| [[Vertigo resident survival guide (pediatrics)|'''Resident'''<br>'''Survival'''<br>'''Guide'''<br> Vertigo in Children]]
|[[Vertigo resident survival guide|'''Resident'''<br>'''Survival'''<br>'''Guide''']]
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|[[File:Siren.gif|30px|link=Chest pain resident survival guide]]||<br>||<br>
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{{CMG}}; {{AE}} {{ZMalik}}  
{{CMG}}; {{AE}} {{ZMalik}}  


{{SK}}  
{{SK}} [[Dizziness]] [[Disequilibrium]] [[Lightheadedness]] [[Presyncope]]
==[[Vertigo overview|Overview]]==


==Overview==
==[[Vertigo historical perspective|Historical Perspective]]==
==[[Vertigo classification|Classification]]==


==Historical Perspective==
==[[Vertigo pathophysiology|Pathophysiology]]==
*Vertigo is derived from the [[Latin]] word vertō which means "a whirling or spinning movement"<ref>"Definition of vertigo". Merriam-Webster Online Dictionary.</ref>.
 
==Classification==
{{familytree/start}}{{familytree | | | | | | | A01 | | | |A01= Classification of Vertigo<ref name="Dieterich2007">{{cite journal|last1=Dieterich|first1=Marianne|title=Central vestibular disorders|journal=Journal of Neurology|volume=254|issue=5|year=2007|pages=559–568|issn=0340-5354|doi=10.1007/s00415-006-0340-7}}</ref><ref name="Karatas2008">{{cite journal|last1=Karatas|first1=Mehmet|title=Central Vertigo and Dizziness|journal=The Neurologist|volume=14|issue=6|year=2008|pages=355–364|issn=1074-7931|doi=10.1097/NRL.0b013e31817533a3}}</ref><ref name="Guerraz2001">{{cite journal|last1=Guerraz|first1=M.|title=Visual vertigo: symptom assessment, spatial orientation and postural control|journal=Brain|volume=124|issue=8|year=2001|pages=1646–1656|issn=14602156|doi=10.1093/brain/124.8.1646}}</ref>}}
{{familytree | | | | | | | |!| | | | | | | | }}
{{familytree | | | | | | | B01 | | | |B01=Based on Location of Dysfunction}}
{{familytree | | |,|-|-|-|-|^|-|-|-|-|.| }}
{{familytree | | C01 | | | | | | | |C02|C01=Peripheral<br>Accounts for over 90% of all causes of vertigo|C02=Central}}
{{familytree | | |!| | | | | | | | | |!| }}
{{familytree | | D01 | | | | | | | |D02|D01=Lesion in inner ear or vestibulocochlear nerve|D02=Lesion in brainstem or cerebellum}}
{{familytree | | |!| | | | | | | | | |!| }}
{{familytree | | E01 | | | | | | | |E02|E01=Meniere’s disease<br>Benign positional paroxysmal vertigo''<br>Acute labyrinthitis''<br>Acute vestibular neuronitis''<br>Cholesteatoma''<br>Otosclerosis''<br>Perilymphatic fistula''<br>Acoustic Neuroma''|E02=Brainstem Stroke<br>Vestibular Migraine''<br>Multiple Sclerosis''<br>Cerebellar ischemia or hemorrhage''<br>Cerebellar tumors''<br>lateral medullary syndrome''<br>Chiari malformation''}}
{{Family tree/end}}
 
==Pathophysiology==
 
==Causes==
* '''Peripheral''' causes of vertigo includes<ref name="Karatas2008">{{cite journal|last1=Karatas|first1=Mehmet|title=Central Vertigo and Dizziness|journal=The Neurologist|volume=14|issue=6|year=2008|pages=355–364|issn=1074-7931|doi=10.1097/NRL.0b013e31817533a3}}</ref>:
{| class="wikitable"
|'''Disease''' ||  '''Main Feature'''
|-
| [[Ménière’s disease]] || Increased [[endolymph]] volume in [[semicircular canals]]. Recurrent vertigo, aural fullness, hearing loss and [[tinnitus]]
|-
| [[Benign positional paroxysmal vertigo]] || Dislodged [[otoliths]] stimulate vestibular sense organ. Recurrent vertigo, nausea, vomiting, [[torsional]] [[nystagmus]]
|-
| Acute [[labyrinthitis]] || Inflammation of [[labyrinth]]/ [[viral]] or [[bacterial]]. Temporary hearing loss, vertigo, off balance, [[tinnitus]]
|-
| Acute [[vestibular]] [[neuritis]] || Inflammation of [[vestibular]] nerve caused by [[viral]] [[infection]]. Vertigo, hearing intact
|-
| [[Cholesteatoma]] || Cyst/sac of [[keratin]] debris in middle ear. Fullness/pressure in the ear, vertigo, hearing loss, pain
|-
| [[Otosclerosis]] || Abnormal bone growth in middle ear. Vertigo, [[tinnitus]] and, sensorineural hearing loss
|-
| [[Perilymphatic fistula]] || Abnormal connection between the middle ear and inner ear. Fullness/pressure in the ear,  vertigo, hearing loss/sensitive hearing
|}


* '''Central''' causes of vertigo includes<ref name="Kerber2009">{{cite journal|last1=Kerber|first1=Kevin A.|title=Vertigo and Dizziness in the Emergency Department|journal=Emergency Medicine Clinics of North America|volume=27|issue=1|year=2009|pages=39–50|issn=07338627|doi=10.1016/j.emc.2008.09.002}}</ref>:
==[[Vertigo causes|Causes]]==
{| class="wikitable"
|'''Disease''' || '''Main Feature'''
|-
| [[Brainstem Stroke]] || Vertigo, imbalance, double vision, slurred speech, and altered [[consciousness]].
|-
| [[Vestibular Migraine]] || Mostly unilateral severe throbbing [[headache]], vertigo lasting minutes to hours, sensitivity to motion/light/smell/noise, [[nausea]], [[vomiting]], imbalance.
|-
| [[Multiple Sclerosis]] || Vertigo may accompany other symptoms like vision problem, fatigue, [[numbness]]/[[tingling]], limited mobility, bladder/bowel/speech/swallowing impairment.
|-
| [[Cerebellar]] [[tumors]] || [[meningioma]] or [[schwannoma]] in [[cerebellopontine]] angle can cause vertigo due to pressure on [[vestibular]] [[nerve]].
|-
| [[Lateral medullary syndrome]] || Results from ischemia in the lateral part of the [[brainstem]]([[medulla oblongata]]). Associated with [[ataxia]], [[nystagmus]], vertigo, [[dysphagia]], [[dysarthria]].
|-
| [[Chiari malformation]] || Extension of brainstem into spinal canal. Associated with [[numbness]]/[[tingling]] of hands and feet, [[dysphagia]], vertigo, unsteady gait, hoarseness.
|}


==Differentiating Vertigo from other Diseases==
==[[Vertigo differential diagnosis|Differentiating Vertigo from other Diseases]]==
*Vertigo must be differentiated from other diseases that cause imbalance, [[dizziness]], and [[lightheadedness]].<ref name="pmid16445269">{{cite journal| author=Labuguen RH| title=Initial evaluation of vertigo. | journal=Am Fam Physician | year= 2006 | volume= 73 | issue= 2 | pages= 244-51 | pmid=16445269 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16445269  }} </ref>


==Epidemiology and Demographics==
==[[Vertigo epidemiology and demographics|Epidemiology and Demographics]]==
*Among the patient who presents with [[dizziness]] in the primary care setting, fifty-four percent have vertigo upon investigation.<ref name="Kroenke1992">{{cite journal|last1=Kroenke|first1=Kurt|title=Causes of Persistent Dizziness|journal=Annals of Internal Medicine|volume=117|issue=11|year=1992|pages=898|issn=0003-4819|doi=10.7326/0003-4819-117-11-898}}</ref>


==Screening==
==[[Vertigo risk factors|Risk Factors]]==
*There is insufficient evidence to recommend routine [[screening]] for vertigo.


==Risk Factors==
==[[Vertigo screening|Screening]]==
*There are no established risk factors for vertigo, as it is a symptom of an underlying disease.
*However, vertigo can be prevented in some cases by controlling the underlying cause:
**In [[vestibular]] [[migraine]] recognized triggers including altered sleep patterns, menstrual cycle, chocolate, red wine, ripened/aged cheese, should be avoided.
**Avoid drugs or toxins that may cause vertigo.


==Natural History, Complications and Prognosis==
==[[Vertigo natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
*Complications include:
**[[Anxiety]]
**[[Depression]]
**Difficulty performing daily tasks
**Diminished quality of life
**Impaired balance and coordination
*[[Prognosis]] of vertigo depends upon treating the underlying cause. However, vertigo due to a tumor has a poor prognosis compared to other causes of vertigo.


==Diagnosis==
==Diagnosis==
'''Diagnostic Study of Choice'''
[[Vertigo diagnostic study of choice|Diagnostic study of choice]] | [[Vertigo history and symptoms|History and Symptoms]] | [[Vertigo physical examination|Physical Examination]] | [[Vertigo laboratory findings|Laboratory Findings]] | [[Vertigo electrocardiogram|Electrocardiogram]] | [[Vertigo chest x ray|Chest X Ray]] | [[Vertigo echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Vertigo CT|CT]] | [[Vertigo MRI|MRI]] | [[Vertigo other imaging findings|Other Imaging Findings]] | [[Vertigo other diagnostic studies|Other Diagnostic Studies]]
 
'''History and Symptoms'''
 
'''Physical Examination'''
 
'''Laboratory Findings'''
 
'''Electrocardiogram'''
 
'''X-ray'''
 
'''Echocardiography or Ultrasound'''
 
'''CT scan'''
 
'''MRI'''
 
'''Other Imaging Findings'''
 
'''Other Diagnostic Studies'''


==Treatment==
==Treatment==
'''Medical Therapy'''
[[Vertigo medical therapy|Medical Therapy]] | [[Vertigo surgery|Surgery]] | [[Vertigo primary prevention|Primary Prevention]] | [[Vertigo secondary prevention|Secondary Prevention]] | [[Vertigo cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Vertigo future or investigational therapies|Future or Investigational Therapies]]
 
'''Surgery'''
 
'''Primary Prevention'''
 
'''Secondary Prevention'''
 
==References==

Latest revision as of 23:38, 7 February 2021



Resident
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Vertigo in Children

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Overview

Historical Perspective

Classification

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Causes

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Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography and Ultrasound

CT

MRI

Other Imaging Findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Zehra Malik, M.B.B.S[2]

Synonyms and keywords: Dizziness Disequilibrium Lightheadedness Presyncope

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Vertigo from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic study of choice | History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | Chest X Ray | Echocardiography or Ultrasound | CT | MRI | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies