Question | Answer |
What is cupulolithiasis? | part of otoconia is floating in canal and sticks onto cupula. With Dix, >60s duration of nystagmus |
What is canalithiasis? | free floating debris in canal bounce off of cupula in certain positions. WIth Dix, <60 s duration of nystagmus |
what type of vestibular dysftn is BPPV? | distorted- different positions will cause nystagmus/vertigo sensation |
what type of vestibular disorder is Post Vestibular Neuritis? | hypoftn due to viral infection of CN 8/ idiopathic |
s/sx of PVN? | severe rotational vertigo, spontaneous horiz nystagmus, imbalance, nausea |
what are causes of hypofunction? | viral infection, age related changes, ototoxicity, trauma, cancer |
what is the px for PVN? | improves in 48-72 h, resolves w/in 6 wks |
what is the px for Meniere's? | most acute sx resolve 24-36 h, near recovery days to wks, cumulative loss over time |
what are s/sx for Meniere's? | episodes of hearing loss/ vestibular dysftn caused by blocked endolymph flow |
what type of vestibular disorder is perilymph fistula? | fluctuating ftn disorder caused by fistula bt middle ear and perilymph. some kind of auditory stimulus then vestib sx. Caused by head trauma (eg diving) |
what type of information does the ABC scale provide? | 16 items of everyday tasks: walk around house, reaching at eye level, pick up slipper from floor, walking in crowded mall, step onto/off escalator. Can pt perform w/o loss of balance/becoming unsteady? |
What is the singleton's test? | Pt walks forward with EC for 3-4 steps, pivots and stops without falling/loss of balance |
what is the fuduka's marching test? | pt marches in place for 50 steps with EC on a grid. Obs whether pt moves fwd/bkwd, side-side |
what is the dixi-hallpike test used for? | it is a DX test for BPPV in the A/P canals. |
Describe the Dix Hallpike Manuever | Pt begins in long sitting, head is turned to 45 degrees. Pt is quickly put into supine, inverted head to 30 degrees. Note onset, duration and direction of nystagmus |
What is the adaptation approach? | Used to address hypofunction pathology. Try to rebalance tonic activity in vestibular nuclei. |
What is the substitution approach? | Helps to address absent vestibular ftn and central deficits. Trying to reweight use of sensory systems, i.e. with visual/somatosensory information |
What is the habituation approach? | Useful for distorted vestibular ftn, like BPPV. Increasing stimulus will decrease respone over time |
What is the point of using repositioning manuevers? | This is used in hopes of moving loose debris through the canal and back into the otolith |
Explain an example of the adaptation approach with VOR/gaze stability. | Visual fixation with head turning. Variables: increase speed of turning, visual background, direction of head mvmt, size of word, sitting/standing, walking on uneven surface |
Indication for Epley? | For canalithiasis of A/P canals |
Indication for Brandt-Daroff ex? | Cupulolithiasis of A/P canals, recalcitrant canalithiasis, habituation |
Indication for habituation exercises? | Nonspecific positional dizziness, central deficits. Sx should decrease with exercises |
What are some exercises for substitution approach in gaze stability? | visual fixation on a stat target; active eye-head mvmt bt two targets, imaginary targets |
Goal is to decrease visual over-reliance. What can you do for Rx? | provide accurate somatosensory inputs, gradually reduce visual inputs, gradually increase need to process visually complex info |
Goal is to decrease over-dependence on somatosens inputs. What can you do for Rx? | reduce ss inputs, gradually reduce surface and visual cues. EX: balance activities on foam, carpet, progress to less visual cues |
Goal: enhance use of vestibular inputs. What can you do for Rx? | Gradually reduce visual/ss inputs. EX: balance activity on foam with decrease BOS, progress by reducing visual cues |
Goal is to improve verticality/alignment. What can you do for Rx? | Use knowledge of results with re: body position, increase sensory fdbk. EX: mirror,midline orientation, cognitive/perceptual retraining |
Goal is to retrain perceptioni of LOS. Use knowledge of results with sway and stability limits, encourage conscious use of surface and visual orientation | Use knowledge of results with sway and stability limits, encourage conscious use of surface and visual orientation inputs. EX sway practice with EO, EC |