Pediatric emergency medicine trisk 0546 0546
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TABLE 24.3
COMMON CAUSES OF PSEUDOVERTIGO
Depression
Anxiety
Hyperventilation
Orthostatic hypotension
Hypertension
Heat stroke
Arrhythmia
Cardiac disease
Anemia
Hypoglycemia
Pregnancy
Ataxia
Visual disturbances
Psychogenic disturbance
Ototoxic Drugs
Most agents that disturb vestibular function will also disturb auditory function.
Specific agents include aminoglycoside antibiotics, furosemide, ethacrynic acid,
streptomycin, minocycline, salicylates, and ethanol. Toxic doses of certain
anticonvulsants and neuroleptics can produce measurable disturbances of
vestibular function, although associated complaints of vertigo are rare.
Trauma
Several mechanisms account for posttraumatic vertigo. The most obvious is
fracture through the temporal bone with damage to the labyrinth (see Chapters
106 ENT Trauma and 113 Neurotrauma ). Presentation includes vertigo, hearing
loss, and hemotympanum. CT scanning or MRI of the temporal bone should be
obtained when there is hemotympanum or posttraumatic evidence of vestibular
dysfunction.
More subtle causes of posttraumatic vertigo include trauma-induced seizures,
migraine, or a postconcussive syndrome. Vestibular concussion typically follows
blows to parietooccipital or temporoparietal regions and presents with headache,
