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Vestibulocochlear (VIII) Nerve Vestibulocochlear (VIII) Nerve Vestibulocochlear (VIII) Nerve Unilateral sensorineural deafness tinnitus loud noise acoustic neuroma Ménière's disease brainstem CVA Pagets disease lead Herpes zoster aminoglycosides neurofibroma furosemide & aspirin Vestibulocochlear (VIII) Nerve vestibular symptoms vertigo is an illusion of motion in the form of a spinning or whirling sensation) It may be associated with Nausea, vomiting, oscillopsia • The presence of associated unilateral hearing loss and tinnitus or fullness in the ear suggests ear pathology. • Signs and symptoms referable to the brainstem, CNs, or cerebellum are indicative of a central lesion Oculocephalic reflex Nystagmus To and fro movement of the eye due to defective control system of vision. Jerk Pendular Vertigo Physiologic Pathologic Visual Seasickness Cerebellar Vestibular (Labyrinthine) Extreme extension Unilateral spin Bilateral • Labyrinthitis • Trauma • Ischemia • Alcohol • drugs Benign paroxysmal position vertigo Recurrent intense dizziness with a spinning sensation and unsteadiness when moving the head in certain directions (recumbent head position) • Nystagmus (in supine with the head turned to the affected ear Causes • tiny fragments of debris in the inner ear labyrinth • drug • strokes • tumors Benign paroxysmal position vertigo Nystagmus central Latency peripheral 3 – 40 sec immediat e Fatigability yes no Habituation yes no direction uindirecti indirectio on n vertical never May be Visual fixation Inhibits vertigo Not inhibited Benign paroxysmal position vertigo Epley maneuver Treatment Antihistamine (meclizine, prmethazine) Benzodiazepine(diazepam, clonazepam) Phenathiazines (prochlorperazine