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Balance Disorders Notes

This is a sample of our (approximately) 5 page long Balance Disorders notes, which we sell as part of the ENT Notes collection, a MBChB (hons) (1st) package written at University Of Leicester in 2014 that contains (approximately) 36 pages of notes across 16 different documents.

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Balance Disorders Vertigo = illusion of movement

Normal balance requires o Accurate sensory information from
 Eyes (vision)
 Proprioceptive receptors
 Vestibular labyrinth o Co-ordination of information in brain o Normal motor output from CNS to intact musculoskeletal system

A fault in any of the above impairs balance

Vertigo is always a symptom of vestibular defects o Severe if accompanied by nausea and vomiting Can be caused by o Peripheral vestibular disorders (BPPV, Menieres', labrynthitis) o Spread of infection from middle ear disease to labyrinth o Central vestibular disorders e.g MS, tumours, infarcts o External insults by drugs, anaemia, hypoglycaemia etc

Benign Paroxysmal Positional Vertigo (BPPV) Commonest cause of vertigo


Detachment of otoconia (calcium carbonate crystals) from the otolith organ of the utricle - fall into posterior semicircular canal (loose inside canal) Cause symptoms on movement of the head


Head injury Viral infection Degenerative changes with aging Idiopathic

Clinical features

Episodic attacks or vertigo provoked by head movements e.g rolling over in bed/looking upwards Violent symptoms but last only seconds No auditory symptoms Episodes usually last for several months before disappearing but often recur Both labyrinths may be affected


Reassurance, advice to avoid provoking head position until recovery Avoid alcohol Epley maneuvers may help reposition otoconia away from the posterior canal Medication o Betahistine

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