Ramsay Hunt syndrome [top]

  • Ear pain
  • Lower motor neurone facial palsy
  • Zoster vesicles at external auditary meatus

Wernicke's encephalopathy [top]

  • Triad of ophthalmoplegia - most often lateral rectus, ataxia and confusion vertigo
  • Caused by thiamine deficiency, usually in alcoholics

Brain stem stroke [top]

  • Sudden onset of vertigo, nystagmus, cerebellar signs
  • May be associated with brainstem cranial nerve signs
  • Risk factors of embolic stroke

Postural hypotension [top]

  • Syncope, dizziness
  • Triggered by lying or sitting to standing
  • >20mmHg postural drop in systolic BP
  • Risk factors: antihypertensives, autonomic neuropathy, dehydration, old age

Meniere's disease [top]

  • Recurrent attacks of Vertigo, tinnitus with vomiting
  • Hearing loss
  • Sensation of fullness
  • Recurrent attacks of vertigo dizziness lasting up to 24 hours
  • Unilateral or bilateral progressive hearing loss or tinnitus
  • Sensation of fullness or pressure in one or both ears

Migraine [top]

  • Acute headache usually with previous similar episodes
  • Typically unilateral and described as pulsating
  • Often preceded by visual, auditory or other aura
  • May be severe with associated nausea, vomiting, photophobia, vertigo
  • May cause transient neurological deficit

Hypoxia [top]

  • Feeling faint dizziness
  • Central cyanosis, confusion
  • Risk factors: Lower respiratory tract infection, other respiratory pathology

Vestibular neuronitis [top]

  • Sudden onset of vertigo and nystagmus in otherwise well individual
  • Absence of other associated symptoms
  • Self limiting but can be severe and disabling

Benign positional vertigo [top]

  • DizzinessVertigo lasting for seconds-minutes following movement of the head or change in position
  • May be associated visual disturbance due to nystagmus and nausea
  • Diagnosed with Hallpike test

Hyperventilation [top]

  • Feeling faint dizziness
  • Tachypnoea, peripheral and perioral paresthesia
  • Feeling of dread / doom

Temporal lobe epilepsy [top]

  • Unusual taste, smells
  • Visual hallucinations
  • Vertigo

Drug-induced vertigo [top]

  • Vertigo
  • History of relevant drug: alcohol, phenytoin, barbituates, gentamycin, quinine, salicylates
  • May be associated nystagmus, slurred speech

Carotid sinus syndrome [top]

  • Syncope, dizziness
  • Triggered by touching neck, turning head etc

Multiple sclerosis [top]

  • Multiple distinct neurological deficits over a period of time
  • Hemiplegia, nystagmus, vertigo, muscle weakness, dysphasia transient neurological deficit
  • Optic atrophy

Vertibrobasilar insufficiency [top]

  • Ischaemia of posterior fossa due to vertebral artery occulsion
  • Classical history is of kinking of neck at hairdresser or turning the neck
  • Symptoms are Dizziness, vertigo, diplopia

Posterior fossa tumour [top]

  • Slowly progressive vertigo, Cerebellar signs
  • Papilloedema
  • Deficit of lower cranial nerves