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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 Revision

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Balance Disorders Vertigo = illusion of movement
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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
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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

Pathophysiology
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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

Aetiology
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Head injury Viral infection Degenerative changes with aging Idiopathic

Clinical features
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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

Management
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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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