Cranial Nerve Symptoms and Disorders
How does vertigo differ from syncope?
Vertigo is the illusion of movement of the body or the environment. It is caused by lesions affecting the labyrinth of the inner ear, the vestibular division of the auditory nerve, or brainstem vestibular nuclei.
Syncope results from the impaired brain supply of blood, oxygen, or glucose.
What are clinical features for benign positional vertigo?
Brief, severe vertigo with nausea and vomiting upon changes in head position.
Most severe in the lateral decubitus position with the affected ear facing down.
Persistence of vertigo for several weeks followed by its spontaneous resolution.
No hearing loss.
What is the Dix-Hallpike maneuver?
Rapid movement from a sitting to a recumbent position with the head 45° below the horizontal plane. This maneuver can induce nystagmus and vertigo. Repetition of this maneuver can attenuate the response.
Also known as Nylen-Barany test.
A 29-year-old woman complains of vertigo and diplopia. Physical examination finds that when she looks to her left, she has nystagmus of the left eye only, with failure of adduction of the right eye. The manifestation pattern of ocular motility in this case suggests the diagnosis of what disease?
Multiple sclerosis.
Internuclear ophthalmoplegia typically presents in people with multiple sclerosis. If the patient was elderly, with symptoms of new onset, the differential diagnosis would include vascular diseases.
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