Sudden hearing loss spontaneous recovery tbi,diy ear wax removal peroxide 2.5,what percentage is hearing loss for disability - Step 2

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Importance Can be a sign of serious diseases Can be seen in other specialties Hard to diagnose because it integrates several organs and systems together and the underlying cause is not clear.
INTRODUCTION Dizziness is a common symptom that accounted for more than 5.6 million clinic visits in the United States 15% to 30% of patients, most often women and the elderly, will experience dizziness severe enough to seek medical attention at some time in their life.
Physiology Function of vestibular system: “Input” resulting from a stimulus that needs to be corrected through the vestibular system such as falling down. It is not surprisingly that vestibular lesion cause: Imbalance posture and gait imbalance visual distortion (oscillopsia ). VERTIGO The word "vertigo" comes from the Latin "vertere", to turn + the suffix "-igo", a condition = a condition of turning about). Vestibular Neuritis Viral infection of vestibular organ Affect all ages but rare in children – mostly adults Affected patient presents acutely with spontaneous nystagmus,vertigo and nausea &vomiting stays for hours and sometimes days. BPPV The most common cause of vertigo in patient > 40 years Repeated attacks of vertigo usually of short duration less than a minute. BPPV Diagnosis History Dix-Halpike maneuver : putting the patient in a certain position to stimulate the attack, and to look at the eye (causes nystagmus) to see which canal is mostly affected by trying to push the particles inside the canal and inducing the sense of dizziness. Migraine associated vertigo (MAV): common in females between the ages of 20 to 35 Classical presentation, preceded by aura or without aura then headache followed by couple of hours of dizziness. Acoustic tumor Benign tumor Arise from vestibular division of VIII Clinical presentation: Unilateral tinnitus Hearing loss Dizziness The only way to differentiate between Meniere's disease and the Acoustic tumor is by MRI.
Spontaneous Intracranial Hypotension (SIH) usually presents as a postural, orthostatic headache, often with subtle and and insidious onset, and occasionally with a sudden, debilitating onset.
The onset of a clearly positional headache with no associated major trauma or prior spinal or neurosurgery leaves little room in the differential.
An MRI scan can be helpful in that highlighting of the dura after gadolinium enhancement is often seen.

Patients who do not have a permanent response to epidural blood patches should under go a CT myleogram with thin cuts.
In many cases, leaking of CSF (often without indentifiable stuctural changes) at their exit through the neuronal formamina, or diverticulae of the dura along the nerve root is noted.
There is some controversy in the literature as to whether the headache is caused by a low pressure situation or a low volume situation. There has been no unifying underlying problem with SIH patients, although a large subset of patients (approximately 20%) seem to have evidence of connective tissue disorders such as Marfan’s Syndrome, polycystic kidney disease, neurofibromatosis Type I, and Lehman Syndrome. If a specific leak site is found on imaging studies, and the patient is refractory to blood patches, an experienced interventional radiologist may attempt a percutaneous placement of fibrin glue to the leak site. Failing this, open surgery with laminectomy at the level of the leak with packing of the area with fibrin glue, gelfoam, blood and muscle has been successful. Bed rest, theophylline therapy, and increasing fluids have not had any signficant success in treating this syndrome, but may offer palliation. This site is for the sharing of experience and knowledge regarding spontaneous intracranial hypotension. An “output” results from responses of the vestibular system to the input such as the eyes, cerebellum..
B) central vestibular loss – above the level of the vestibular nerve and towards the brain. Patient requires only symptomatic treatment It takes 3 weeks to recover from vestibular neuritis Diagnosis – no other tool other than history. Pathophysiology: Calcium carbonate particles shear off and enter the canal leading to brief episodes of vertigo.
Provoked by cert" title="BPPV The most common cause of vertigo in patient > 40 years Repeated attacks of vertigo usually of short duration less than a minute. Treatment: repositioning of the head to get particles out of the canal (Epley or particle repositioning maneuver).

On reviewing the study, attention should be directed to evidence of leakage at the nerve roots and the presence of diverticulae of the dura of the nerve roots.
More frequently the patient might complain of nausea when smelling something in the car or while driving around. Placing 15 to 20 ml of autologous blood in the lumbar epidural space should result in a marked improvement, if not resolution, of the patient’s symptoms. Note that radionucleotide scans of the spine looking for CSF leaks have proven much less sensitive than the CT myleogram method. People need hard surfaces to get the full effect of their proprioception or it will feel like they are walking on sand “ shaky grounds”. The physical stimulus (input) will be transformed into a biological stimulas in the brain stem which will in turn be sent afterwards to the corresponding areas in the vestibular system.
Some patient’s headaches transition from postural to non-postural and stop responding to epidural blood patches.
Transform of the forces associate with head acceleration and gravity into a biological signals that the brain can use to develop subjective awareness of head position in space (orientation) produce motor reflexes that will maintain posture and ocular stability to prevent the feeling of dizziness.
Being pushed from behind will lead to all the previous systems to work together to maintain balance.
If there is a defect in the input and output processes the patient will present with vertigo, defects in the gait or ocular distortions.

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