35 CLINICAL EVALUATION OF BALANCE

Question 1

How dies the vestibular ocular reflex work

Answer 1

Pathway to ocular motor neurons so that they move the eye in the opposite direction to head movement

Question 2

Define nystagmus

Answer 2

A rhythmic oscillation of the eyes with a fast and slow phase. The direction of the fast phase determines the direction of the nystagmus

Question 3

What would a left beating nystagmus signal

Answer 3

Hypo function in the right ear or hyper function in the left ear.

Question 4

Describe the head thrust

Answer 4

Tilt patients head down 30 degrees
Instruct patient to fixate on your nose
Quickly rotate 15-20 degrees to one side then the other
Eyes should remain on nose
Negative will produces saccade on side of pathology e.g. turn you head to right if instead of eye staying central it moves to right then saccade to get back to central, pathology in right vestibular system.

Question 5

Describe COWS

Answer 5

In calorics putting cold water in ear simulates hypo function in that ear, fast phase of nystagmus will move to the opposite ear. Warm will cause nystagmus to same side

Question 6

Describe FUKUDA test

Answer 6

Stepping on spot with eyes closed. If pathology will move towards side of lesion

Question 7

Describe Dix Hallpike

Answer 7

Lower patient quickly to a supine position with head over back of bed 30 degrees with head at 45 degree angle (to side). Assess for benign paroxysmal positional vertigo. If BPPV then vertigo and nystagmus occur

Question 8

Define BPPV

Answer 8

Benign paroxysmal positional vertigo. Common. due to inner ear crystals coming loose and moving around

Question 9

What manoeuvre is used to correct BPPV

Answer 9

The Epley’s manoeuvre.