Exam 2: Vestibular Examination Flashcards
What are the four main vestibular diagnoses?
- BPPV
- Unilateral hypofunction
- Bilateral hypofunction
- Central
What is the definition of VOR?
Maintains stability of an image on the fovea of the retina during rapid head movements
What direction do the eyes and head move during VOR?
Eyes will more the opposite of the head
What is the definition of VOR Gain?
Relationship of eye velocity to head velocity – head and eyes move in opposite directions are equal speeds
What is the definition of VOR Phase?
Relationship of amplitude between the eyes and head – equal
What value is considered a healthy VOR Phase?
0 Phase Shift
What is the Inhibitory Cut-Off?
Inhibition can only be recorded to a firing rate of 0
Describe an intact inhibitory cut-off
When you turn your head quickly to the right, the right vestibular system is responsible for detecting the change
Describe an impaired inhibitory cut-off
When you turn your head quickly to the right, the right side vestibular system is not able to excite to the capacity it needs to
The opposite side cannot help because it is inhibited at 0 spikes/second
What is the definition of UVH?
One vestibular apparatus is hypofunctioning with a low tonic firing rate
What are common diagnoses that can lead to UVH?
Vestibular neuritis, labyrinthitis, Meniere’s, Perilymph Fistula, Vestibular Schwannoma/Acoustic Neuroma, chronic BPPV
What percentage of people will experience a fall since the onset of UVH?
30%
What are the two possible vestibular dysfunction that can result from an infection?
Vestibular neuritis or labyrinthitis
What is vestibular neuritis?
Inflammation of the vestibular part of the nerve that results in vertigo only
What is vestibular labyrinthitis?
Inflammation of both branches of CN VIII that results in vertigo and hearing loss
Differentiate between the symptoms of vestibular neuritis and labyrinthitis
Neuritis only results in vertigo while labyrinthitis results in vertigo and hearing loss
What is Meniere’s Disease?
Abnormal fluctuations in endolymphatic fluid
What population is more likely to develop Meniere’s?
Females between 40-60
How long does a Meniere’s flare up last?
2-4 hours
What are symptoms of Meniere’s?
Low frequency hearing loss, episodic vertigo, sense of fullness in ears, tinnitus, nausea and vomitting
Is is recommended to perform vestibular rehab during a Meniere’s flare up?
No – it is contraindicated
What can result from chronic Meniere’s Disease?
UVH, will require rehab
What is the treatment for Meniere’s Disease?
Balance fluids by reducing fluid buildup, reduced sodium diet, avoid caffeine, alcohol, and smoking, surgical intervention
What is a Perilymph Fistula?
Rupture of the oval or round window that separates the middle from the inner ear