Approach to Disorders of Equilibrium

Question 1

What does the Romberg Test test?

Answer 1

Proprioceptive system – judge posture/body awareness

Question 2

What test can test the Proprioceptive system?

Answer 2

Romberg test

Question 3

Describe how the Romberg test is performed?

Answer 3

Patient stands with feet together, arms out straight and eyes closed

Question 4

Illusion of movement of oneself or objects around

Answer 4

Vertigo

Question 5

Nonvertiginous state of altered balance

Answer 5

Disequilibrium

Question 6

BPV

Answer 6

Benign Positional Vertigo

Question 7

Benign Positional Vertigo (BPV) is triggered by what?

Answer 7

Changes in head position

Question 8

What test can confirm BPV?

Answer 8

Dix-Hallpike test

Question 9

What does the Dix-Hallpike test confirm?

Answer 9

Benign Positional Vertigo

Question 10

BPV usually resolves, however what are recommended treatments?

Answer 10

Exercises or vestibular therapy

Question 11

Vestibular Neuronitis also involves vertigo, but what does it not have that BPV does?

Answer 11

Tinnitus and is NOT positional

Question 12

What are the symptoms of Meniere’s Disease?

Answer 12

1. Vertigo
2. LOW frequency hearing loss
3. Tinnitus
4. Feeling of fullness in the ear

Question 13

What are the symptoms of Meniere’s Disease?

Answer 13

1. Vertigo
2. LOW frequency hearing loss
3. Tinnitus
4. Feeling of fullness in the ear

Question 14

What causes Meniere’s Disease?

Answer 14

Increase in labyrinthine endolymph

Question 15

Meniere’s Disease is episodic, what is the best treatment?

Answer 15

Low sodium diet

Question 16

When does Friedrich’s Ataxia usually present?

Answer 16

Before age 20

Question 17

What are the first symptoms with Friedreich’s Ataxia?

Answer 17

• Gait ataxia

- Decreased strength, sensation, DTRs

Question 18

Although patients with Friedreich’s Ataxia have decreased sensorimotor signs and DTRs, what will still be (+)?

Answer 18

Extensor plantar reflex

Question 19

How do patients with Friedrich’s Ataxia usually die?

Answer 19

Cardiomyopathies

Question 20

What are the (3) symptoms seen with Ataxia-Telangiectasia?

Answer 20

• Ataxia
• Telangiectasias
• Immune insufficiency (low IgG/IgA)