zrana.org
Zulfiqar Rana, MD, MPH, FACP
Board Certified in Internal Medicine
Category Archives: Neurology
Dizziness and Vertigo
Posted by on January 9, 2020
Differential Diagnosis
From: AAFP
The TITRATE approach
From: TiTrATE: A Novel Approach to Diagnosing Acute Dizziness and Vertigo
David E. Newman-Toker and Jonathan A. Edlow
Work-Up
History:
- t-EVS
- BPPV
- orthostatic hypotension
- DANGEROUS: internal bleeding, POTS, intrathoracic emergencies, intrabdominal emergencies.
- s-EVS
- Meniere’s disease
- vestibular migraine
- vasovagal syncope
- panic attacks
- DANGEROUS: TIA (do ABCD’s) and cardiac arrhythmias
- t-AVS
- post-exposure – blunt head trauma
- post-exposure – medications esp. anti-convulsants, CO exposure, aminoglycosides
- s-AVS
- Vestibular Neuritis
- DANGEROUS: Stroke (lateral brainstem, cerebellum, inner ear), Wernicke’s encephalopathy, listeria encephalitis.
PHYSICAL EXAM:
- Vitals – BP
- Vitals – pulse
- vitals – orthostatic BP
- Gait and Romberg
- HInts exam
- Head impulse
- Nystagmus
- Test of Skew
- Dix-Hallpike maneuver
LABS:
- CBC, CMP
- ?UA
- Imaging
Miscellaneous
HINTS exam
ARTICLE
https://www.emra.org/emresident/article/hints-exam/
VIDEO 2
Dix Hallpike Maneuver
The Romberg Test
Updated Guidelines on Secondary Stroke Prevention – Neurology
Posted by on March 13, 2011
About one in four strokes that occur annually are recurrent events. The American Heart Association/American Stroke Association has now updated its 2006 evidence-based recommendations for the prevention of stroke among survivors of ischemic stroke or transient ischemic attack (TIA). The guidelines include recommendations, rated by class (degree of treatment effect) and evidence level, for risk-factor control, antithrombotic therapies, interventional approaches for atherosclerotic disease, and treatment of unusual stroke mechanisms.
via Updated Guidelines on Secondary Stroke Prevention – Neurology.
Epley’s
Posted by on March 1, 2011
This exercise works great for BPPV, a kind of vertigo. Try it and see if it works for you.
Diet News
- Sugar is processed differently in the brains of obesity-prone vs. obesity-resistant rats
- Study finds obesity-related neurodegeneration mimics Alzheimer's disease
- Why a high fat diet could reduce the brain's ability to regulate food intake
- Supplementation with amino acid serine eases neuropathy in diabetic mice
- Loneliness associated with unhealthful diets and physical inactivity among US college students
- Body Dissatisfaction Can Lead to Eating Disorders at Any Age
- Study explores effects of dietary choline deficiency on neurologic and system-wide health
Health News
- Kentucky Bourbon Trail attendance reaches record heights
- AMC to charge more for good seats in movie theaters
- Russia sentences popular cookbook author over Ukraine posts
- Super Bowl draws epic air show of private planes to Phoenix
- Valentine's Day is a perfect excuse to make fudgy brownies
- Eight-ingredient beef, bean chili hides Super Bowl surprise
- Liz Weston: ‘Bridge’ your way to Social Security
Zulfiqar Rana, MD, MPH, FACP 