VERTIGO

PERIPHERAL CENTRAL
Nystagmus

Direction

Horizontal/Horizontorotary

Never purely torsional
Any

Laterality

Never unilateral Any
Hallpike's test

Latency

Delayed Short

Duration

Transient Sustained

Intensity

Variable Mild

Fatiguability

Yes No

Visual fixation

Supressed Variable
Other Tinnitus/Deafness Cranial nerve involvement
Direction of spin to fast phase Variable
Direction of fall to slow phase Variable
Causes Benign positional vertigo
Labyrithitis
Meniere's disease
Vestibular neuronitis
Acoustic neuroma
Vertebro-basilar insufficiency
Subclavian steal
Wallenberg syn
Cerebellar haemoorhage
Multiple sclerosis
Perilymphatic fistula
Vertebro-basilar migraine

RED FLAG FEATURES

Hallpike's test

INVESTIGATION

Usually none required unless a central cause of vertigo is identified --> CT brain

TREATMENT

DISPOSAL

Discharge after treatment:

Admit