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Ask Dr. Arun Phophalia Your Own Question

Dr. Arun Phophalia
Dr. Arun Phophalia, Prof. in surgery
Category: Homework
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Experience:  MBBS, MS, Fellowship (post doctoral) in sports medicine
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Vertigo question

Customer Question

Vertigo Question


 


 


This question is for Dr Arun only! Hi Dr. Arun, Vertigo question 1. What are the causes and symptoms of objective vertigo 2. What are the causes nad symptoms of subjective vertigo. I know subjective vertigo is when patient feels they are spinning. Objective vertigo is when patient feels the enviornment is spinning. I tried to send this question to you but they put it under homework and it did not reach you because you were off line. Thank you, Lisa

Submitted: 6 months ago.
Category: Homework
Expert:  Dr. Arun Phophalia replied 6 months ago.

Hello and welcome, Lisa.

The causes of vertigo according to the decreasing incidence are;

 

1) Benign paroxysmal positional vertigo (BPPV) 20%

2) Vestibular 15%

3) Migraine and motion sensitivity 15%

4) Anxiety and depression 10%

5) Meniere's disease 7%

6) Cerebellar disease 6%

7) Transient ischemic attacks 5%

8) Orthostatic hypotension 4%

9) Other

 

Internal ear disease vertigo is termed true vertigo in which one feels rotational movement of self or the surroundings. The false vertigo or nonvertigo has feeling of light-headedness, unsteadiness, motion intolerance, imbalance, etc.

The causes of subjective vertigo are;

1) Cerebellar disorders
2) BPPV
3) Internal ear diseases / vestibular.

The causes of objective vertigo are;

1) Migraine
2) Anxiety and panic

3) Motion sensitivity

4) Orthostatic hypotension

Acute vertigo is usually managed with;

1) vestibular suppressants,
2) antiviral medication,
3) antiemetic medications
4) steroids

Vestibular rehabilitation can help which is an exercise program.

Exercises are graded in difficulty based on velocity of head and object motion and by progression of body positioning from sitting to standing to walking. The exercises are graded in difficulty by narrowing the base of support, making the surface uneven, or changing the surface from firm to soft. Varied walking exercises are graded in difficulty by changing direction, requiring performance with the eyes closed, increasing speed of ambulation, walking on soft surfaces, or navigating stairs. An aerobic exercise home program progressively increasing the time, speed, or distance that the patient could tolerate also can be initiated. But all of these may need supervision of a doctor if vertigo is severe.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.



It is great privilege helping you.

Unfortunately the previous question was miscategorized. Please post the questions in the health category.

Thank you.

Customer: replied 6 months ago.


Hi Dr. Arun,


 


Glad I was able to get you. The last question was under health and someone changed it to homework, so I was not able to get you. So I redid the question without stating what it was for.


The problem with the virtigo question is the instructor wants the objective and subjective vertigo. I had found a lot of what you wrote. Very little on specifically subjective and objective.


What is happening in the ear with subjective vs objective. I need to know the difference. Still not clear. For example is it an infection of the labrythe (sp) that causes subjective vertigo and something else causes objective vertigo?


Thank you,


Lisa

Expert:  Dr. Arun Phophalia replied 6 months ago.
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Customer: replied 6 months ago.

So these are centrally located and thus objective (patient feels room spinning) causes ?
1) Migraine
2) Anxiety and panic


3) Motion sensitivity


4) Orthostatic hypotension


And these are subjective ( patient feels they are spinning) peripherie causes ?


1) Cerebellar disorders
2) BPPV
3) Internal ear diseases / vestibular.


So peripheral vertigo is subjective and central vertigo is objective? Is that correct or am I off base?


 


Thanks Lisa

Expert:  Angela--Mod replied 6 months ago.

Hello. I am a moderator for this topic. I apologize for any confusion: homework questions are limited to the homework categories. Please let me know if you still need assistance and we will search for a professional to assist you. Thank you for your understanding.

Best,

Angela

Customer: replied 6 months ago.

Dr. Arun,



So these are centrally located and thus objective (patient feels room spinning) causes ?
1) Migraine
2) Anxiety and panic




3) Motion sensitivity




4) Orthostatic hypotension




And these are subjective ( patient feels they are spinning) peripherie causes ?




1) Cerebellar disorders
2) BPPV
3) Internal ear diseases / vestibular.




So peripheral vertigo is subjective and central vertigo is objective? Is that correct or am I off base?




 




Thanks Lisa








Customer: replied 6 months ago.


Angela,


 


I had gone back on the site and reentered the question under health and payed a second time. What happened to that part and why am I back in homework when I was in health and talking with Dr. Arun??


 


Thank you,


Lisa

Expert:  Angela--Mod replied 6 months ago.

Hello. I apologize for the confusion. The $30 for your duplicate question was refunded. Homework questions are restricted to the homework category, hence the change. I have reopened this question to all the professionals for this topic and marked your question high priority so they know you need an answer right away. We appreciate your understanding.

Best,

Angela

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