Biography
Biography: Birendra Kumar Pankaj
Abstract
Vertigo is a relevant clinical symptom and patients with vertigo have more distress and disability. Vertigo has been classified as peripheral and central according to site of lesion and also depending on the duration. There are many clinical examination and tests to differentiate central and peripheral vertigo.
Cardiovascular examination, head, neck and ear examination and bedside examination of the vestibular and ocular motor systems are essential for diagnosis of vertigo and their management. Head impulse test, Rhombergs test, Dix hall pipe maneuver, Head tilt test, Supine roll test, Hearing test and ocular tilt reaction are some of important bed side tests. Eng and Vng are some important laboratory tests.
Vestibular paroxysmia, benign postural vertigo, perilymph tic fistula and phobic postural vertigo are some important short duration differentials. Mennier's disease, Vestibular migraine, Tia and episodic ataxia type 2 are some of long duration differentials.
Vertbrobasilar stroke, vestibular neuritis, bilateral vestibulopathy, degenerative disease (cerebellar ataxia), multifactorial vertigo in the elderly, somatoform/ phobic vertigo are some more prolonged duration differentials. Treatment of vertigo varies according to the cause and vestibular rehabilitation is one of the important aspects of management along with ant vertigo drugs. Dose and duration of anti-vertigo medication varies according to cause of vertigo. Surgery is also required in few diseases causing vertigo when conservative therapy fails.