BPPV Screening / Examination Flashcards
What is considered the most important part of an examination?
The Subjective portion
Characteristics of Symptoms
Quality
Frequency
Duration
Aggravating / Easing Factors
Other / associated symptoms
What are three examples of Movement-Related “Dizziness”?
Vertigo / Disequilibrium / Gaze-Instability
Presence of any could indicate vestibular issue
Vertigo (Definition)
Illusion of movement (spinning / rocking / swaying / falling)
BPPV
Disequilibrium (Definition)
Sense of being off-balance (unsteady / wobbly / drunk / tilted)
Gaze-Instability (Definition)
Foggy-headed / heavy-headed / light-headed / motion sickness
Non-BPPV
Cardiovascular-Related “Dizziness”
Decreased blood flow to the brain
Light-headed / pre-syncope / tunnel vision
Take vitals!!
Anxiety-Related “Dizziness”
Floating / swimming / rocking
Visual-Related “Dizziness”
Diplopia / Oscillopsia (vision jumping)
Mal de Debarquement
Sense of rocking / swaying as if on a ship
Holding very still makes it better
Vestibular Neuritis / Labyrinthitis Symptom Duration
Sudden onset / acute
Lasting days
Single event
BPPV Symptom Duration
Short spells (seconds)
Recurring
Bilateral Hypofunction Symptom Duration
Gradual onset over months / years
Constant / chronic
MDDS or PPPD Symptom Duration
Constant
Fluctuating severity
Chronic
BPPV Aggravating / Easing Factors
Aggravating Factors: Positional (lying down / sitting up or turning over in bed / bending forward)
Easing Factors: Holding still / time
Gaze-Instability Aggravating / Easing Factors
Aggravating Factors: Head movement / visual-vestibular mismatch
Easing Factors: Holding still / closing eyes
Imbalance Aggravating / Easing Factors
Aggravating Factors: Walking / darkness / unstable surfaces / standing up
Easing Factors: Sitting / support from UEs
Vestibular Neuritis Aggravating / Easing Factors
Aggravating Factors: Spontaneous / exacerbated by head movement
Easing Factors: Holding still / closing eyes / medication
Vestibular Screen - Systems Review (Comorbidities)
Diabetes
BP
Auto-immune conditions
Anxiety
Depression
Peripheral Neuropathy
Which medications act as vestibular suppressants?
Meclizine
Dramamine
Valium
___ is a common medication side-effect. What can you do if your patient is taking these types of medications?
Dizziness
Check with PCP to see if pt can stop taking meds (vestibular suppressants) so that symptoms can be provoked
Define Ototoxicity. What can cause this?
Affecting the whole vestibular system (bilaterally)
Can be caused by some antibiotics / chemotherapy / some diuretics / some NSAIDs
What should you ask the pt about regarding Diagnostic Tests?
Imaging
Vestibular Tests (Audiograp, VNG / ENG)
Posturography
Blood work
How does fixation affect a Peripheral Vestibular dysfunction? Central Vestibular?
