Term
| what are some potential causes of dizziness |
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Definition
| vertigo, precyncope, dysequilibrium, medications, other problems |
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Term
| what are the 2 types of causes of vertigo |
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Definition
| periopheral vestibular problem or involvement of central connections |
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Term
| what are some causes of vertigo |
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Definition
| BPPV, ear infections, viral neurolabyrinths, meniere's disease |
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Term
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Definition
| inadequate blood or nutrient supply to the brain due to hypotension, vasovagal attacks, hyperventilation, reduced cardiac output |
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Term
|
Definition
| impaired balance without abnormal head sensation |
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Term
| what causes dysequilibrium |
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Definition
| vestibular loss, proprioceptive or somatosensory loss, motor and cerebellar lesion |
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Term
| what are some other causes of dizziness? |
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Definition
| medications, psychiatric, hyperventilation, encephalopathies, vertebrobasilar insufficiency, acoustic neuroma, trauma, migraine, anxiety, solvent exposure, otosclerosis, perilymphatic fistula, MS |
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Term
| what is perceptual disorientation |
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Definition
| disorientation relative to gravity/position |
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Term
| what are symptoms of unilateral vestibular hypofunction |
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Definition
| Appear stable in sitting with head still. Severe vertigo, nausea. Static and dynamic VSR and VOR deficits. Nystagmus initially, resolves in daylight. Ataxic gait. Ataxia with head movement. Positive head thrust test. |
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Term
| what is the prognosis for unilateral vestibular hypofunction |
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Definition
| Good with central compensation. Adaptation can occur quickly. |
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Term
| what are treatments for unilateral vestibular hypofunction |
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Definition
| exercises to improve VOR compensations. Habituation exercises to reduce symptoms. Postural control activities. Work on musculoskeletal issues caused by holding head still. |
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Term
| what are two reasons a person might have bilateral vestibular hypofunction |
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Definition
| ototoxicity from -mycin antibiotics. Common in adults with CF |
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Term
| what are symptoms of bilateral vestibular hypofunction |
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Definition
| No signs of static VOR deficit, but severe dynamic disturbance of VSR and VOR. Oscillopsia. Reduction in acuity with movement. Positional changes don't increase symptoms. Less stability when visual and/or somatosensory cues are altered. Wide based, ataxic gait. Visual problems and postural instability |
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Term
|
Definition
| surroundings jump or slip |
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Term
| what is the prognosis for bilateral vestibular hypofunction |
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Definition
| slower recovery than uilateral deficits. Postural stability will never be normal. Increased fall risk; may need assistive device. Must continue to exercise. |
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Term
| how to treat someone with bilateral vestibular hypofunction |
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Definition
| adaptation exercises. Analyze functional activities for safety. Education. If the patient has no remaining vestibular function, substitute visual/somatosensory cues for gaze and postural stability. |
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Term
|
Definition
| benign paroxysmal positional vertigo |
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|
Term
| what causes benign paroxysmal positional vertigo |
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Definition
| trauma (TBI); age-associated vestibular change; meniere's disease; viruses affecting inner ear; post-surgery; idopathic |
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|
Term
| what are symptoms of BPPV |
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Definition
| vertigo 1-40 seconds; onset with positional change: nystagmus appears with vertigo, usually stops within 60 seconds. Dependent on position, usually with affected ear down. |
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|
Term
| what is the prognosis for BPPV |
|
Definition
| often resolves spontaneously. Good response to positioning maneuver and habituation exercises |
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Term
|
Definition
|
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Term
| particularly what type of BPPV does Dix Hallpike test for |
|
Definition
| posterior semicirucular canal |
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|
Term
| how to do Dix Hallpike test |
|
Definition
| 1. Have patient longsitting on the mat, head rotated 45 deg toward test side. 2. Rapid transition to supine with head extended 30 deg and rotated. 3. Hold 45s and look for nystagmus or ask for onset of vertigo. 4. wait for nystagmus to stop and return to sit |
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|
Term
| how to treat BPPV after positive Dix Hallpike |
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Definition
| modified Epley maneuver or Brandt Daroff exercises |
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|
Term
| how to do a modified Epley maneuver |
|
Definition
| 1. Begin in the provoking Dix-Hallpike position. 2. move head slowly in the opposite direction 3. return to vertical with head facing floor. 4. remain upright for 48 hours. Avoid provoking position for 1 week |
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|
Term
| what is a good accoutrement for dix-hallpike test |
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Definition
|
|
Term
| how to do Brandt Daroff exercises |
|
Definition
| repeatedly move into provoking position 15-20 times. Repeat every 3 hrs. Do this until you have 2 days without symptoms |
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|
Term
| when would you do brand daroff exercises |
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Definition
| for persistent or mild vertigo or unable to tolerate canalith repositioning maneuver |
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|
Term
| what are symptoms of central vestibular deficit |
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Definition
| nausea, less vertigo. Imbalance. Postural control more involved. Oscillopsia that affects postural control. |
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|
Term
| what is the prognosis for central vestibular deficit? |
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Definition
|
|
Term
| how to treat central vestibular deficit |
|
Definition
| postural control. Peripheral dysfunction treatments. |
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|
Term
| what to do in eval for dizziness |
|
Definition
| history, medications, test results. VOR testing. Positional testing. Head thrust. Postural control assessment |
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|
Term
| what is the best clinical tool to elicit VOR problems |
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Definition
|
|
Term
|
Definition
| patient focuses on your nose. 30 deg flexion to test horizontal canal. High speed movement in an unpredictable direction. Patient's gaze should stay on your nose. Abnormal if you see a corrective saccade |
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Term
| if you get a corrective saccade with head turning to the right, what side is the lesion on? |
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Definition
|
|
Term
| how to do VOR cancellation test |
|
Definition
| head thrust + you move your head too |
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|
Term
| if a person has movement induced symptoms with duration < 1 minute, what does that indicate? |
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Definition
|
|
Term
| if a person has symptoms with duration > 12 hours, what does that indicate |
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Definition
|
|
Term
| what does the Dynamic Visual Acuity test for? |
|
Definition
|
|
Term
| how to do dynamic visual acuity test |
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Definition
| read snellen chart with head still then with movement 2Hz. |
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|
Term
| reduction by how many lines in snellen chart indicates vestibular deficit? |
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Definition
|
|
Term
| what is the purpose of gaze stability exercises |
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Definition
| cause retinal slip that trigger improvement in vestibular response |
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|
Term
| describe gaze stability exercises X1 |
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Definition
| head moves, eyes stay still |
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|
Term
| describe gaze stability exercises X2 |
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Definition
| head and eyes move in opposite directions |
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|
Term
| what to look for in VOR gaze stability exercises |
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Definition
| nystagmus, catch-up saccades, increased symptoms, inability to speed up |
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|
Term
| how to assess postural control |
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Definition
| timed stability in different positions. Romberg. Functional activities that involve balance. Responses to perturbations. Postural control in altered sensory conditions. |
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Term
| what are some funcitonal measures of postural control |
|
Definition
| functional reach, Berg, TUG, Tinetti, DGI, PPT |
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Term
| what are some strategy measures |
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Definition
| postural stress test, Clinical Test of Sensory Interaction in Balance (foam and dome), Balance Master |
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Term
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Definition
| like clinical test of sensory interaction in balance - change eyes open/closed, surface, sway-referenced platform. Tests movement coordination. Can be used for training |
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Term
| who to collaborate with for vestibular patients |
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Definition
| primary care physician: vestibular supressants can reduce rehab potential; ENT; audiology |
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