Causes of Vertigo, benign paroxysmal, in childhood
Vertigo, benign paroxysmal, in childhood Causes: Book Excerpts
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Vertigo:
Differential Diagnosis
(In A Page: Pediatric Signs and Symptoms)
-
Benign paroxysmal positional vertigo (BPPV)
–Each episode lasts seconds to minutes
-
Vestibular neuritis
–Viral infection of the vestibular nerve
-
Otitis media
-
Migraine
–Vertigo may precede, follow, or present with the headache and aura
-
Acute labyrinthitis
–Acute onset with nausea and vomiting
–Lasts for days and slowly resolves
–45% cluster with viral infections
-
Posttraumatic
–Perilymphatic fistula
–Labyrinthine concussion
–Associated with postconcussive syndrome
–Worsened by change in head position, cough, sneeze, swallow, straining, and airplane travel
-
Cerebellar tumors
–Tumors may be associated with tinnitus, facial weakness, and nystagmus
-
Toxins/drugs: Antibiotics (aminoglycosides), salicylates, alcohol, phenytoin, quinine, arsenic, tricyclic antidepressants
-
Autoimmune: Collagen vascular disease, Wegener granulomatosis
-
Posterior circulation dissection
–Often associated with a history of neck extension or rotational injury
-
Cerebellar hemorrhage: Acute onset of vertigo, headache, nausea, and vomiting
-
Multiple sclerosis
–Vertigo is the presenting symptom in 5%
–Hearing loss rare
–Most common in young women
-
Temporal lobe or complex partial seizures
-
Ménière disease
-
Familial periodic ataxia syndromes
–Recurrent bouts of vertigo brought on by emotional stress or physical exertion
-
CNS infection: Syphilis, Lyme disease
-
Motion sickness
-
Vertigo mimics: Presyncope, disequilibrium from decreased vision or proprioception
-
Psychogenic
–Panic or anxiety disorder
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Vertigo:
Medical causes
(Handbook of Signs & Symptoms (Third Edition))
Acoustic neuroma
Acoustic neuroma is a tumor of the eighth cranial nerve that causes mild, intermittent vertigo and unilateral sensorineural hearing loss. Other findings include tinnitus, postauricular or suboccipital pain, and — with cranial nerve compression — facial paralysis.
Benign positional vertigo
With benign positional vertigo, debris in a semicircular canal produces vertigo on head position change, which lasts a few minutes. It’s usually temporary and can be effectively treated with positional maneuvers.
Brain stem ischemia
Brain stem ischemia produces sudden, severe vertigo that may become episodic and later persistent. Associated findings include ataxia, nausea, vomiting, increased blood pressure, tachycardia, nystagmus, and lateral deviation of the eyes toward the side of the lesion. Hemiparesis and paresthesia may also occur.
Head trauma
Persistent vertigo, occurring soon after injury, accompanies spontaneous or positional nystagmus and, if the temporal bone is fractured, hearing loss. Associated findings include headache, nausea, vomiting, and decreased (LOC). Behavioral changes, diplopia or visual blurring, seizures, motor or sensory deficits, and signs of increased intracranial pressure may also occur.
Herpes zoster
Infection of the eighth cranial nerve produces sudden onset of vertigo accompanied by facial paralysis, hearing loss in the affected ear, and herpetic vesicular lesions in the auditory canal.
Labyrinthitis
Severe vertigo begins abruptly with labyrinthitis, an inner ear infection. Vertigo may occur in a single episode or may recur over months or years. Associated findings include nausea, vomiting, progressive sensorineural hearing loss, and nystagmus.
Ménière’s disease
With Ménière’s disease, labyrinthine dysfunction causes abrupt onset of vertigo, lasting minutes, hours, or days. Unpredictable episodes of severe vertigo and unsteady gait may cause the patient to fall. During an attack, any sudden motion of the head or eyes can precipitate nausea and vomiting.
Multiple sclerosis (MS)
Episodic vertigo may occur early and become persistent. Other early findings include diplopia, visual blurring, and paresthesia. MS may also produce nystagmus, constipation, muscle weakness, paralysis, spasticity, hyperreflexia, intention tremor, and ataxia.
Seizures
Temporal lobe seizures may produce vertigo, usually associated with other symptoms of partial complex seizures.
Vestibular neuritis
With vestibular neuritis, severe vertigo usually begins abruptly and lasts several days, without tinnitus or hearing loss. Other findings include nausea, vomiting, and nystagmus.
Other causes
Diagnostic tests
Caloric testing (irrigating the ears with warm or cold water) can induce vertigo.
Drugs and alcohol
High or toxic doses of certain drugs or alcohol may produce vertigo. These drugs include salicylates, aminoglycosides, antibiotics, quinine, and hormonal contraceptives.
Surgery and other procedures
Ear surgery may cause vertigo that lasts for several days. Also, administration of overly warm or cold eardrops or irrigating solutions can cause vertigo.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Vertigo:
Medical causes
(Professional Guide to Signs & Symptoms (Fifth Edition))
Acoustic neuroma
This tumor of the eighth cranial nerve causes mild, intermittent vertigo and unilateral sensorineural hearing loss. Other findings include tinnitus, postauricular or suboccipital pain, and—with cranial nerve compression—facial paralysis.
Benign positional vertigo
In this disorder, debris in a semicircular canal produces vertigo lasting a few minutes when the patient changes head position. This type of vertigo is usually temporary and can be effectively treated with positional maneuvers.
Brain stem ischemia
This condition produces sudden, severe vertigo that may become episodic and later persistent. Associated findings include ataxia, nausea, vomiting, increased blood pressure, tachycardia, nystagmus, and lateral deviation of the eyes toward the side of the lesion. Hemiparesis and paresthesia may also occur.
Head trauma
Persistent vertigo, occurring soon after a head injury, accompanies spontaneous or positional nystagmus and, if the temporal bone is fractured, hearing loss. Associated findings include headache, nausea, vomiting, and decreased level of consciousness. Behavioral changes, diplopia or visual blurring, seizures, motor or sensory deficits, and signs of increased intracranial pressure may also occur.
Herpes zoster
Infection of the eighth cranial nerve produces sudden onset of vertigo accompanied by facial paralysis, hearing loss in the affected ear, and herpetic vesicular lesions in the auditory canal.
Labyrinthitis
Severe vertigo begins abruptly in this inner ear infection. Vertigo may occur in a single episode or may recur over months or years. Associated findings include nausea, vomiting, progressive sensorineural hearing loss, and nystagmus.
Ménière’s disease
In this disease, labyrinthine dysfunction causes abrupt onset of vertigo, lasting minutes, hours, or days. Unpredictable episodes of severe vertigo and unsteady gait may cause the patient to fall. During an attack, any sudden motion of the head or eyes can precipitate nausea and vomiting.
Motion sickness
This condition is characterized by vertigo, nausea, vomiting, and headache in response to rhythmic or erratic motions.
Multiple sclerosis (MS)
Episodic vertigo may occur early and become persistent in MS. Other early findings include diplopia, visual blurring, and paresthesia. MS may also produce nystagmus, constipation, muscle weakness, paralysis, spasticity, hyperreflexia, intention tremor, and ataxia.
Posterior fossa tumor
This type of tumor may produce positional vertigo that lasts for a few seconds as well as papilledema, headache, memory loss, nausea, vomiting, nystagmus, apneustic or ataxic respirations, and increased blood pressure. The patient may also fall sideways.
Seizures
Temporal lobe seizures may produce vertigo, usually associated with other symptoms of partial complex seizures.
Vestibular neuritis
In this disorder, severe vertigo usually begins abruptly, lasts several days, and isn’t accompanied by tinnitus or hearing loss. Other findings include nausea, vomiting, and nystagmus.
Other causes
Diagnostic tests
Caloric testing (irrigating the ears with warm or cold water) can induce vertigo.
Drugs and alcohol
High or toxic doses of certain drugs or alcohol may produce vertigo. These drugs include salicylates, aminoglycosides, antibiotics, quinine, and hormonal contraceptives.
Surgery and other procedures
Ear surgery may cause vertigo that lasts for several days. Administration of overly warm or cold eardrops or irrigating solutions can also cause vertigo.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Vertigo:
Medical causes
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Acoustic neuroma
Acoustic neuroma is a tumor of the eighth cranial nerve that causes mild, intermittent vertigo and unilateral sensorineural hearing loss. Other findings include tinnitus, postauricular or suboccipital pain, and — with cranial nerve compression — facial paralysis.
Benign positional vertigo
With benign positional vertigo, debris in a semicircular canal produces vertigo on head position change, which lasts a few minutes. It’s usually temporary and can be effectively treated with positional maneuvers.
Brain stem ischemia
Brain stem ischemia produces sudden, severe vertigo that may become episodic and later persistent. Associated findings include ataxia, nausea, vomiting, increased blood pressure, tachycardia, nystagmus, and lateral deviation of the eyes toward the side of the lesion. Hemiparesis and paresthesia may also occur.
Head trauma
Persistent vertigo, occurring soon after injury, accompanies spontaneous or positional nystagmus and, if the temporal bone is fractured, hearing loss. Associated findings include headache, nausea, vomiting, and decreased level of consciousness (LOC). Behavioral changes, diplopia or visual blurring, seizures, motor or sensory deficits, and signs of increased intracranial pressure may also occur.
Herpes zoster
Infection of the eighth cranial nerve with herpes zoster produces sudden onset of vertigo accompanied by facial paralysis, hearing loss in the affected ear, and herpetic vesicular lesions in the auditory canal.
Labyrinthitis
Severe vertigo begins abruptly with this inner ear infection. Vertigo may occur in a single episode or may recur over months or years. Associated findings of labyrinthitis include nausea, vomiting, progressive sensorineural hearing loss, and nystagmus.
Ménière’s disease
With Ménière’s disease, labyrinthine dysfunction causes abrupt onset of vertigo, lasting minutes, hours, or days. Unpredictable episodes of severe vertigo and unsteady gait may cause the patient to fall. During an attack, any sudden motion of the head or eyes can precipitate nausea and vomiting.
Motion sickness
Motion sickness is characterized by vertigo, nausea, vomiting, and headache in response to rhythmic or erratic motions. Headache, dizziness, fatigue, diaphoresis, hypersalivation, and dyspnea may also occur.
Multiple sclerosis
Episodic vertigo may occur early in multiple sclerosis and become persistent. Other early findings include diplopia, visual blurring, and paresthesia. Multiple sclerosis may also produce nystagmus, constipation, muscle weakness, paralysis, spasticity, hyperreflexia, intention tremor, and ataxia.
Seizures
Temporal lobe seizures may produce vertigo, usually associated with other symptoms of partial complex seizures. The seizures may be heralded by an aura and followed by several minutes of mental confusion.
Vestibular neuritis
With vestibular neuritis, severe vertigo usually begins abruptly and lasts several days, without tinnitus or hearing loss. Other findings include nausea, vomiting, and nystagmus.
Other causes
Diagnostic tests
Caloric testing (irrigating the ears with warm or cold water) can induce vertigo.
Drugs and alcohol
High or toxic doses of certain drugs or alcohol may produce vertigo. These drugs include salicylates, aminoglycosides, antibiotics, quinine, and hormonal contraceptives.
Surgery and other procedures
Ear surgery may cause vertigo that lasts for several days. Also, administration of overly warm or cold eardrops or irrigating solutions can cause vertigo.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Vertigo:
Principal Causes of Vertigo
(The Diagnostic Approach to Symptoms and Signs in Pediatrics)
- Peripheralvestibular dysfunction
- Labyrinthitis
- Motion sickness
- Head trauma
- Drugs
- Benign paroxysmal vertigo
- Vestibular neuronitis
- Middle ear and temporal bone masses
- Perilymphatic fistula
- Ménière disease
- Central vestibular dysfunction
- Head trauma
- Intracranial infection
- Seizure disorder
- Basilar artery migraine
- Neoplasm
- Psychologic disturbance
» READ BOOK EXCERPT ONLINE »
Source: The Diagnostic Approach to Symptoms and Signs in Pediatrics, 2006
Vertigo:
Medical causes
(Nursing: Interpreting Signs and Symptoms)
Acoustic neuroma.Acoustic neuroma causes mild, intermittent vertigo and unilateral sensorineural hearing loss. Other findings include tinnitus, postauricular or suboccipital pain, and—with cranial nerve compression—facial paralysis.
Benign positional vertigo.With benign positional vertigo, debris in a semicircular canal produces vertigo with head position change, which lasts a few minutes. It's usually temporary and can be effectively treated with positional maneuvers.
Brain stem ischemia.Brain stem ischemia produces sudden, severe vertigo that may become episodic and later persistent. Associated findings include ataxia, nausea, vomiting, increased blood pressure, tachycardia, nystagmus, and lateral deviation of the eyes toward the side of the lesion. Hemiparesis and paresthesia may also occur.
Head trauma.Persistent vertigo, occurring soon after head injury, accompanies spontaneous or positional nystagmus and, if the temporal bone is fractured, hearing loss. Associated findings include headache, nausea, vomiting, and decreased (LOC). Behavioral changes, diplopia or visual blurring, seizures, motor or sensory deficits, and signs of increased intracranial pressure may also occur.
Herpes zoster.Herpes infection of the eighth cranial nerve produces sudden onset of vertigo accompanied by facial paralysis, hearing loss in the affected ear, and herpetic vesicular lesions in the auditory canal.
Labyrinthitis.Severe vertigo begins abruptly with labyrinthitis. Vertigo may occur in a single episode or may recur over months or years. Associated findings include nausea, vomiting, progressive sensorineural hearing loss, and nystagmus.
Ménière's disease.With Ménière's disease, labyrinthine dysfunction causes abrupt onset of vertigo, lasting minutes, hours, or days. Unpredictable episodes of severe vertigo and unsteady gait may cause the patient to fall. During an attack, a sudden motion of the head or eyes can precipitate nausea and vomiting.
Multiple sclerosis (MS).With MS, episodic vertigo may occur early and become persistent. Other early findings include diplopia, visual blurring, and paresthesia. MS may also produce nystagmus, constipation, muscle weakness, paralysis, spasticity, hyperreflexia, intention tremor, and ataxia.
Seizures.Temporal lobe seizures may produce vertigo, usually associated with other symptoms of partial complex seizures.
Vestibular neuritis.With vestibular neuritis, severe vertigo usually begins abruptly and lasts several days, without tinnitus or hearing loss. Other findings include nausea, vomiting, and nystagmus.
Other causes
Diagnostic tests.Caloric testing (irrigating the ears with warm or cold water) can induce vertigo.
Drugs and alcohol.High or toxic doses of certain drugs or alcohol may produce vertigo. These drugs include salicylates, aminoglycosides, antibiotics, quinine, and hormonal contraceptives.
Surgery and other procedures.Ear surgery may cause vertigo that lasts for several days. Administration of overly warm or cold eardrops or irrigating solutions can also cause vertigo.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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