• See Also
  1. Vertigo
  2. Vertigo Causes
  3. Central Causes of Vertigo
  4. Vertigo Management
  5. Meniere's Disease
  6. Motion Sickness
  7. Vestibular Neuronitis
  8. Benign Paroxysmal Positional Vertigo
  9. Perilymphatic Fistula (Hennebert's Sign)
  10. Acute Labyrinthitis
  11. Bacterial Labyrinthitis (Acute Suppurative Labyrinthitis)
  12. HiNTs Exam (Three-Step Bedside Oculomotor Examination)
  13. Horizontal Head Impulse Test (Head Thrust Test, h-HIT)
  14. Nystagmus
  15. Skew Deviation (Vertical Ocular Misalignment, Vertical Heterotropia, Vertical Strabismus)
  16. Dix-Hallpike Maneuver
  17. Dizziness
  18. Dysequilibrium
  19. Syncope
  20. Light Headedness
  • Findings
  • Suggestive of peripheral causes
  1. Pathognomonic for peripheral cause
    1. Sudden onset with brief episodes often on awakening
    2. Rotary Illusion with Nausea, Vomiting
  2. Nystagmus
    1. Combined horizontal and torsional Nystagmus
    2. Persists 5-20 seconds after Dix-Hallpike Maneuver
    3. Fixation of eyes on object inhibits Nystagmus
  3. Moderate imbalance
  4. Nausea or Vomiting
  5. Associated findings
    1. Hearing Loss
    2. Tinnitus
  6. Tullio's Phenomenon
    1. Nystagmus and Vertigo provoked by loud sounds
  • Causes
  • Common (Peripheral Vertigo)
  1. Acute Vestibular Neuronitis
  2. Benign Paroxysmal Positional Vertigo
  3. Meniere's Disease
  • Causes
  • Other (Peripheral Vertigo)
  1. Ear Infections
    1. Serous Otitis Media
    2. Chronic Otitis Media
    3. Otitis Externa
    4. Mastoiditis
  2. Other infections
    1. Herpes Zoster Oticus (Ramsay Hunt Syndrome)
    2. Acute Labyrinthitis (uncommon)
      1. Not synonymous with Vestibular Neuronitis
        1. Labyrinthitis is much less common than Neuronitis
        2. Labyrinthitis causes permanent Hearing Loss
      2. Types
        1. Viral Labyrinthitis
        2. Bacterial Labyrinthitis (Rare)
  3. Structural disorder
    1. Cholesteatoma
    2. Perilymphatic Fistula
    3. Otosclerosis
  4. Trauma
    1. Temporal Bone Fracture
    2. Labyrinthine Concussion
  • References
  1. Baloh (1999) Postgrad Med 105(2):161-72 [PubMed]
  2. Knox (1997) Am Fam Physician 55(4):1185-90 [PubMed]
  3. Labuguen (2006) Am Fam Physician 73:244-51 [PubMed]
  4. Tusa (2005) Neurol Clin 23:655-673 [PubMed]
  5. Tusa (2003) Med Clin N Am 87:609-41 [PubMed]