Pediatric emergency medicine trisk 0547 0547
Bạn đang xem bản rút gọn của tài liệu. Xem và tải ngay bản đầy đủ của tài liệu tại đây (70.54 KB, 1 trang )
nausea, vertigo, and nystagmus. Although it generally remits with time,
intermittent and recurrent episodes can occur. Hyperextension and flexion
(“whiplash”) injuries can be associated with vestibular dysfunction, probably
caused by basilar artery spasm with subsequent impairment of their labyrinth and
cochlear connections. Symptoms may mimic basilar artery migraine or cerebellar
stroke.
Seizures
Two types of seizures are associated with vertigo: vestibular seizures (seizures
causing vertigo) and vestibulogenic seizures (“reflex” seizures brought on by
stimulating the semicircular canals or vestibules by sudden rotation or caloric
testing). Vestibular seizures, the more common type, consist of sudden onset of
vertigo with or without nausea, emesis, and headache, and are followed by loss or
alteration of consciousness. The EEG is abnormal and anticonvulsants may be of
benefit.
Motion Sickness
Motion sickness is precipitated by a mismatch in information provided to the
brain by the visual and vestibular systems during unfamiliar rotations and
accelerations. The most common situation occurs when a child travels in a car or
airplane and is deprived of a visual stimulus that confirms movement. Symptoms
include vertigo, nausea, and nystagmus. Attacks can be prevented by allowing
patients to watch the environment move in a direction opposite to the direction of
body movement (such as encouraging a child to look out the window while riding
in a car).
Ménière Disease
Uncommon in children younger than 10 years, Ménière disease is characterized
by episodic attacks of vertigo, hearing loss, tinnitus, nystagmus, and autonomic
symptoms of pallor, nausea, and emesis. The underlying cause is believed to be
an overaccumulation of endolymph within the labyrinth, which causes a rupture
(endolymphatic hydrops). Typical attacks last from 1 to 3 hours and usually begin
with tinnitus, a sense of fullness within the ear, and increasing hearing
impairment. The patient may have intermittent attacks for years, and there may be
permanent hearing loss.
Miscellaneous Causes
Vertigo may occur at any point in the clinical course of multiple sclerosis when
the central demyelination interferes with the vestibular nuclei in the brainstem or
