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Medical history, your current and past these abnormalities include hypothyroidism, hyperthyroidism, hyperlipidemia because of the multifactorial nature.

07.03.2015

Acute labyrinthitis differential diagnosis, ginkgo biloba tinnitus research - Test Out

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Vertical nystagmus is 80 percent sensitive for vestibular nuclear or cerebellar vermis lesions.2 Spontaneous horizontal nystagmus with or without rotatory nystagmus is consistent with acute vestibular neuronitis. The main causes of vertigo are benign paroxysmal positional vertigo, Meniere disease, vestibular neuritis, and labyrinthitis. A systolic blood pressure decrease of 20 mm Hg, diastolic blood pressure decrease of 10 mm Hg, or pulse increase of 30 beats per minute is indicative of orthostatic hypotension.16,19The Dix-Hallpike maneuver (Figure 19,16) is diagnostic for BPPV if positive, but does not rule it out if negative. A thorough neurologic and cardiovascular examination should be performed in all patients, as well as targeted components of the physical examination based on suspicion of the underlying diagnosis. Parkinson disease and diabetic neuropathy should be considered with the diagnosis of disequilibrium.


The differential diagnosis of dizziness can be narrowed with easy-to-perform physical examination tests, including evaluation for nystagmus, the Dix-Hallpike maneuver, and orthostatic blood pressure testing. Nystagmus is diagnostic of vestibular debris in the ear that is facing down, closest to the examination table. For example, in acute vestibular neuronitis, initial symptoms typically are severe but lessen over the next few days.
Patients complaining of constant vertigo lasting for weeks may have a psychological cause for their symptoms.PROVOKING FACTORSProvoking factors and circumstances around the onset of vertigo may prove useful in narrowing the differential diagnosis to a peripheral vestibular condition.
If symptoms occur only with positional changes, such as turning over in bed,17 bending over at the waist and then straightening up, or hyperextending the neck, BPPV is the most likely cause.1 A recent viral upper respiratory infection may precede acute vestibular neuronitis or acute labyrinthitis.


Disequilibrium and lightheadedness can be alleviated by treating the underlying cause.Diagnosing the cause of dizziness can be difficult because symptoms are often nonspecific and the differential diagnosis is broad.
However, a few simple questions and physical examination tests can help narrow the possible diagnoses. For example, a history of anxiety or panic attacks associated with vertigo may point to hyperventilation as a cause.12ASSOCIATED SYMPTOMSHearing loss, pain, nausea, vomiting, or neurologic symptoms can help differentiate the cause of vertigo.




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