Clinical Evaluation of Balance

Question 1

Vestibular occular reflex example, left vestibule turning left

Goal?

Answer 1

Causes movement of cupula, firing of the vestibular nerve to the vestibular nuclei.
This causes your eyes to turn to the right, by stabilisng images on the retina

Goal: eye movement equal and opposite to head movement

Question 2

COWS

Answer 2

Cold opposite warm same

A dysfunction in one side (cold) will cause a nystagmus on the other side, so a right side pathology causes a left (fast phase) nystagmus (the jerking motion)

Question 3

Head thrust test

Answer 3

To test the horizontal (superior nerve) and posterior (inf nerve) canals bu thrusting the head in the plane of the canal and looking for nystagmus

Horizontal canal, 30 degree down
Posterior canal 45 degrees

Question 4

BBPV

test?

Answer 4

Benign Paroxysmal positional vertigo
Self limiting vertigo that lasts about minute.
Associated with movements of head positions

Dix Hallpike test: head at 45 degrees lay then down on bed and put head 30 degress below and look for nystagmus

Question 5

Vertigo management

Answer 5

Elderly: keep eyes open and maximise enviornmental contact

Question 6

How is nystagmus described?

Answer 6

In the direction of the fast phase (COWS)

Question 7

What will vestibular hypofunction produce in the head thrust test and the fukuda step test?

Answer 7

Positive for the side that has the lesion, e.g left sided lesion will show positive head thrust with a right sided nystagmus, and a step that goes to the left

Question 8

Dix Hallpike and Epley maneuver

Answer 8

watch videos?