Case Studies Flashcards
“SOME CENTER GAZE NYSTAGMUS OBSERVED: EYES BEAT TO THE PATIENT’S LEFT (INCREASED WITH LEFTWARD GAZE, ABATES WITH RIGHTWARD GAZE).”
“DEMONSTRATES CORRECTIVE SACCADE WITH RIGHT HEAD IMPULSE, NONE TO LEFT.”
Alexsnders Phenomena w/ Right side vestibulopathy peripheral
Spontaneous Nystagmus & left beating nystagmus
* Nystagmus beats away from affected ear
* Alexanders Phenomena because
* Gaze in the direction of the fast phase, Nystagmus Increases = peripheral
* The patient has central nystagmus (center gaze or spontaneous), to rule out if it is peripheral or central have them gaze to the left and right, if there is a an increase on one side then alexander’s phenomenon = peripheral
HIT
* VOR in direction of lesion of lesion you get corrective saccades in the same direction of the vestibular loss = right vestibular loss
* Right side vestibulopathy - because corrective saccades to right & left beating nystagmus
Left: Gain a little low but mostly normal
* since the good ear may have reduced its gain (static compensation)
Right: covert & overt saccades
* uncompensated right sided vestibular loss
SN: Present Nystagmus - eliminate w/fixation & left beating= peripheral & right affected side
HS: When you tax the system with a headshake you are amplifying the asymmetry
the more you work system the more noticeable it will be
SR: Normal
Normal
Normal
win/ normal gain
Horizontal Left beating Nystagmus
no torsional = not A/P BPPV
- Peripheral and right side affected
Diagnosis: Acute Uncompensated Right Vestibular Loss
Treatment: Vest rehab w/PT
Lateral: Covert & Overt saccades, Low Gain
Posterior: Covert & Overt saccades, Low Gain
Anterior: Covert & Overt saccades, Low Gain
Looking more global
Hypoactive - BVL
Bilateral Vestiblar Loss
* reduced gain on RC
* Hypoactive
Majority is within normal range
