Central vestibular disorders Flashcards
1
Q
cerebellum
A
- accepts information form the vestibular nuclei
- an adaptive processor
- provides adjustments for the vestibular reflexes
- provides input to many areas of the central vestibular system
2
Q
vestibule-cerebellum (flocculonodular lobe)
A
- interaction site between peripheral vestibula information and eye movement
- mediates VOR gain
- modulates smooth pursuit
- otoliths input relay
3
Q
spino-cerebellum
A
- accepts lower extremity information
- mediates VSR, coordinates postural control
- lesions include gait ataxia and truncal instability
4
Q
central vestibular disorders
A
- vascular TBI -cerebellar degeneration migraine epilepsy demyelinating diseases tumors degenerative changes
5
Q
vertigo in central disorders are uncommon but can occur in:
A
- root entry zone lesions
- lateral medullary infarcts
- cerebellar infarctions
- migraine
6
Q
common manifestations of central vestibular disorders
A
- lateropulsion
- subjective visual vertical
- ocular tilt reaction
- oculomotor abnormalities
7
Q
oculomotor abnormalities
A
- saccadic abnormalities
- impaired VOR cancellation
- direction changing nystagmus
- down beating nystagmus
- saccadic smooth pursuit
8
Q
cerebellar infarcts
A
- occlusion of the vertebral PICA, AICA
- symptoms: vertigo, nausea with vomiting, ataxia
-clinical findings: oculomotor abnormalities, may mimic peripheral vestibular loss
9
Q
PICA: lateral medullary syndrome
A
- Wallenberg’s or PICA syndrome
- common brainstem CVA
- symptoms: vertigo, dysarthria, altered perception of vertical, ataxia. loss of pain and temp- ipsi on face, contra on body
10
Q
PICA clinical findings
A
- horizontal nystagmus
- ips OTR
- ipsipulsive saccades
- hemiataxia, dysarthria, lateropulsion, dysdiadochokinesia
- ips horner’s syndrome
11
Q
AICA: lateral pontomedullary syndrome
A
- occlusion of dorsolateral pontomedullary region , inferior cerebellum, membranous labyrinth an d8th nerve
- Symptoms: vertigo, imbalance, altered perception of vertical, loss of pain and temp - ipsi on face, contra on body
- hearing loss
12
Q
AICA: clinical findings
A
- similar to PICA
- gaze evoked nystagmus
- ipsilateral facial weakness
- unilateral hearing loss more common in AICA than PICA infarcts
13
Q
Labyrinthine concussion:
A
- most common type of TBI that causes vestibular injury
- BPPV may also be present
- symptoms: dizziness, ataxia, hearing loss, imbalance
14
Q
labyrinthine frcature
A
- temporal bone fracture
- longitudinal- 70-90% of temporal bone frcatures
- oblique - inner ear vestibular compromise complete loss of labyrinthine function
15
Q
head trauma
A
- symptoms
- acute: hearing loss, vertigo, nausea and vomiting
- chronic: persistent hearing loss, hea dmotion intolerance, postural instability when vision is unavailable or distracting
