Vertigo causes: Difference between revisions

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==Causes==
==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"
{| class="wikitable"
|'''Disease''' || '''Main Feature'''
|+
|-
! colspan="2" |Peripheral Vertigo Causes<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>
| [[Ménière’s disease]] || Increased [[endolymph]] volume in [[semicircular canals]]. Recurrent vertigo, aural fullness, hearing loss and [[tinnitus]]
|-
|-
![[Ménière’s disease]]
| [[Acoustic neuroma]] || [[tinnitus]], ear pain, [[aural fullness]], [[headache]], facial weakness.
|
|-
*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]]
|-
|-
![[Acoustic neuroma]]
| Acute [[labyrinthitis]] || Inflammation of [[labyrinth]]/ [[viral]] or [[bacterial]]. Temporary hearing loss, vertigo, off balance, [[tinnitus]]
|
|-
*[[tinnitus]], ear pain, [[aural fullness]], [[headache]], facial weakness.
| Acute [[vestibular]] [[neuritis]] || Inflammation of [[vestibular]] nerve caused by [[viral]] [[infection]]. Vertigo, hearing intact
|-
|-
![[Benign paroxysmal positional vertigo]]
| [[Cholesteatoma]] || Cyst/sac of [[keratin]] debris in middle ear. Fullness/pressure in the ear, vertigo, hearing loss, pain
|
|-
*Dislodged [[otoliths]] stimulate vestibular sense organ. Recurrent vertigo, nausea, vomiting, [[torsional]] [[nystagmus]]
| [[Otosclerosis]] || Abnormal bone growth in middle ear. Vertigo, [[tinnitus]] and, sensorineural hearing loss
|-
|-
![[Acute]] [[labyrinthitis]]
| [[Perilymphatic fistula]] || Abnormal connection between the middle ear and inner ear. Fullness/pressure in the ear,  vertigo, hearing loss/sensitive hearing
|
|}
*Inflammation of [[labyrinth]]/ [[viral]] or [[bacterial]]. Temporary hearing loss, vertigo, off balance, [[tinnitus]]  
 
|-
* '''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>:
![[Acute vestibular neuritis]]
{| class="wikitable"
|
|'''Disease''' || '''Main Feature'''
* Inflammation of [[vestibular]] nerve caused by [[viral]] [[infection]]. Vertigo, hearing intact
|-
|-
| [[Brainstem Stroke]] || Vertigo, imbalance, double vision, slurred speech, and altered [[consciousness]].
![[Herpes Zoster Oticus]]
|-
|
| [[Vestibular Migraine]] || Mostly unilateral severe throbbing [[headache]], vertigo lasting minutes to hours, sensitivity to motion/light/smell/noise, [[nausea]], [[vomiting]], imbalance.
* Ear pain, [[facial palsy]], hearing loss, [[tinnitus]] vertigo herpetic eruptions of the [[auricle]] and/or [[external auditory canal]].
|-
|-
| [[Multiple Sclerosis]] || Vertigo may accompany other symptoms like vision problem, fatigue, [[numbness]]/[[tingling]], limited mobility, bladder/bowel/speech/swallowing impairment.
![[Cholesteatoma]]
|-
|
| [[Cerebellar]] [[tumors]] || [[meningioma]] or [[schwannoma]] in [[cerebellopontine]] angle can cause vertigo due to pressure on [[vestibular]] [[nerve]].
*[[Cyst]]/sac of [[keratin]] debris in middle ear. Fullness/pressure in the ear, vertigo, hearing loss, pain
|-
|-
| [[Lateral medullary syndrome]] || Results from ischemia in the lateral part of the [[brainstem]]([[medulla oblongata]]). Associated with [[ataxia]], [[nystagmus]], vertigo, [[dysphagia]], [[dysarthria]].
![[Otosclerosis]]
|-
|
| [[Chiari malformation]] || Extension of brainstem into spinal canal. Associated with [[numbness]]/[[tingling]] of hands and feet, [[dysphagia]], vertigo, unsteady gait, hoarseness.  
*Abnormal bone growth in the middle ear. Vertigo, [[tinnitus]] and, sensorineural hearing loss
|}
|+
*Other Causes<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>:
! colspan="2" |Central Vertigo Causes<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>
{| class="wikitable"
|-
|'''Disease''' ||  '''Main Feature'''
![[Brainstem]] [[Stroke]]
|-
|
| Medication induced |[[aminoglycosides]], [[anticonvulsants]]([[phenytoin]]), [[anti-depressants]]([[tricyclic antidepressants]], [[monoamine oxidase]]), [[antihypertensives]], [[diuretics]] ([[furosemide]]), [[barbiturates]], [[cocaine]], [[nitroglycerin]], [[salicylates]]
*Vertigo, imbalance, double vision, slurred speech, and altered [[consciousness]].
|-
|-
| Psychogenic|| Mood, anxiety, or alcohol abuse disorders
![[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.
|-
![[Cerebellopontine angle]] [[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.
|+
! colspan="2" |Other Causes
|-
!Medication induced
|
*[[Aminoglycosides]], [[anticonvulsants]]([[phenytoin]]), [[anti-depressants]]([[tricyclic antidepressants]], [[monoamine oxidase]]), [[antihypertensives]], [[diuretics]] ([[furosemide]]), [[barbiturates]], [[cocaine]], [[nitroglycerin]], [[salicylates]]
|-
![[Psychogenic]]
|
*Mood, [[anxiety]], or [[alcohol]] abuse disorders  
|}
|}
*Life threatening causes of Vertigo:
*Life threatening causes of Vertigo:

Revision as of 03:01, 7 January 2021

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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]

Overview

Common causes of vertigo are Ménière’s disease, benign positional paroxysmal vertigo, labyrinthitis, vestibular neuritis. Life threatening causes to look for include brainstem ischemia/hemorrhage, hypertension crisis, drug overdose, cyanide poisoning.

Causes

Peripheral Vertigo Causes[1]
Ménière’s disease
Acoustic neuroma
Benign paroxysmal positional vertigo
Acute labyrinthitis
Acute vestibular neuritis
Herpes Zoster Oticus
Cholesteatoma
  • Cyst/sac of keratin debris in middle ear. Fullness/pressure in the ear, vertigo, hearing loss, pain
Otosclerosis
  • Abnormal bone growth in the middle ear. Vertigo, tinnitus and, sensorineural hearing loss
Central Vertigo Causes[2]
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.
Cerebellopontine angle tumors
Lateral medullary syndrome
Chiari malformation
Other Causes
Medication induced
Psychogenic

References

  1. name="Karatas2008">Karatas, Mehmet (2008). "Central Vertigo and Dizziness". The Neurologist. 14 (6): 355–364. doi:10.1097/NRL.0b013e31817533a3. ISSN 1074-7931.
  2. Kerber, Kevin A. (2009). "Vertigo and Dizziness in the Emergency Department". Emergency Medicine Clinics of North America. 27 (1): 39–50. doi:10.1016/j.emc.2008.09.002. ISSN 0733-8627.

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