Medicine (MD/DO)
USMLE Step 2
Neurology, Ophthalmology & Otology
Vertigo & Balance Disorders

Master Vertigo with Picmonic for Medicine

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Vestibular Neuritis
Vest-ball and membranes with neuron tail

Vestibular neuritis is a common cause of peripheral vertigo and it often follows upper respiratory infections. This condition is caused by an inflammation of the vestibular nerve, this nerve transmits information about the positional changes and when the inflammation compromises its function, patients can develop a sense of imbalance.

Benign Paroxysmal Positional Vertigo
Benign-bunny on positional-bed

Benign Paroxysmal Positional Vertigo (BPPV) is the most common cause of vertigo. It is caused by an abnormal movement of otoliths in the semicircular canals, hence the symptoms (eg, vertigo, nystagmus) are induced by positional changes and are short-lived.
Reproduction of symptoms on the Dix-Hallpike maneuver is diagnostic and Epley maneuver (canalith repositioning procedure) can be used to treat this disorder.

Meniere's Disease

This is a condition of the inner ear of unknown origin but characterized by excess endolymph in the vestibular and semicircular canals, causing increased fluid pressure in the inner ear; also known as endolymphatic hydrops. Symptoms usually begin between 30 to 60 years of age. Attacks are sudden and severe and may last hours or days.
The typical triad of Meniere's disease consists of tinnitus, sensorineural hearing loss, and vertigo.

Brainstem Or Cerebellum
Brainstem on circular-boat with silver-bell-rotor

Central vertigo is usually caused by lesions in the brainstem or cerebellum. Causes of central vertigo include but aren't limited to cerebral vascular accidents affecting vestibular nuclei (eg, lateral medullary syndrome, lateral pontine syndrome), neoplasms, and demyelinating disorders.

Vertical Nystagmus

Purely vertical nystagmus is a characteristic feature of central vertigo. Other important features include diplopia (double vision), dysmetria (coordination defect), focal neurologic signs, and skew deviation (vertical misalignment of the eyes).


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