H

1
H P
VERTIGO
History Exam
DIZZINESS
Meds for acute sx n/v
Dimenhydrin./Dramamine 50-100mg PO
q4-6h Metoclopramide/Reglan 5-10mg PO
q6-8h Prochlorperaz./Compazine 5-10mg PO
q6-8h, 25mg PR q12h Promethazine/Phenergan
12.5-25mg PO/PR q4-6h
Perip Central
PRESYNCOPE
common etiologies
Central
Peripheral
Duration of episodes
Duration of episodes
days-wks
sec-hrs
sec-hrs
days-wks
1.Migraines 2.TIA
MRI
Dix-Hallpike Maneuver
1.Labyrinthitis 2.Vestibular neuronitis 3.Acoust
ic neuroma 4.Ototoxicity 2/2 meds 5.Endohypothyro
id,DM
_

1.Menieres 2.Anxiety
1.CVA 3.Cerebellar degen/mass 2.MS
4.Acoustic neuroma
BPPV
By Patrick Chen 8/1/05
Swartz R, Longwell P. Treatment of Vertigo.
American Family Physician 2005171115-21.
2
Dix-Hallpike maneuver. (A) Turn patient's head 45
degrees to the right. (B) Support the head as the
patient lies back quickly, with the head hanging
20 degrees off the table for 30 seconds. Then
return patient to the upright position and
observe for 30 seconds. Repeat maneuver with
patient's head turned to the left. Positive test
if vertigo induced by any of these
maneuvers. Epley maneuver. Perform (A) and (B).
(C) Turn patient's head 90 degrees to the left
side and hold for 30 seconds. (D) Turn patient's
head another 90 degrees to the left while patient
rotates body 90 degrees in the same direction for
30 seconds. (E) Patient sits up on the left side
of the table.
Swartz R, Longwell P. Treatment of Vertigo.
American Family Physician 2005171115-21.