[MND] Vestibular Disorders

Question 1

Peripheral Vestibular Disorders are caused by?

Answer 1

A disturbance of the vestibular organs in the inner ear

Question 2

Central Vestibular Disorders are caused by?

Answer 2

A disturbance of the central vestibular pathway

i.e. by brain stem or cerebellar tumours; brain injury/concussion; MS; Migraine; Brainstem or Cerebellar Stroke

Question 3

What are some examples of peripheral vestibular disorders?

Answer 3

• Benign Paroxysmal Positional Vertigo (BPPV)
• Labyrinthitis
• Vestibular Neuritis

Question 4

What is Benign Paroxysmal Positional Vertigo (BPPV) caused by?

Answer 4

Caused by detachment of the otoconia from the gelatinous membrane of the vestibule (most likely utricle)

Question 5

‘Wandering otoconia’ moving into semicircular canals and either floating in the canals or sticking to the capula is known as what disorder?

Answer 5

Benign Paroxysmal Positional Vertigo (BPPV)

a peripheral vestibular disorder

Question 6

What canal is the most commonly affected with Benign Paroxysmal Positional Vertigo (BPPV)?

Answer 6

Posterior Canal

Question 7

Is it a central vestibular disorder if the cerebellum and brain stem are affected?

Answer 7

Yes

Question 8

The VOR can assess if it is a ____________ vestibular disorder

Answer 8

Peripheral

Question 9

Smooth Pursuits, VOR cancellation, saccades can assess if it is a ___________ vestibular disorder

Answer 9

Central

Question 10

What symptoms would differentiate a central vestibular disorder from peripheral?

Answer 10

ataxia, visual disturbances (i.e. double/blurred vision), dysarthria, headaches, misalignment (head tilt), neurological signs =

Question 11

In Benign Paroxysmal Positional Vertigo (BPPV) hearing is

Answer 11

Not affected

Question 12

What is some instructions for post Benign Paroxysmal Positional Vertigo treatment plan?

Answer 12

• Encourage otoconia to remain in place

- Avoiding at risk positions (i.e. avoid sleeping on affected side, sleeping upright)

Question 13

What is Habituation?

Answer 13

Reducing symptoms through repetitive exposure to movement and the central processing involved in accommodation
(i.e. 5x reps, 1-2x a day)

Question 14

Labrynthitis is a vestibular crisis improving over

Answer 14

1-4 days

Question 15

What are some symptoms the patient will feel with Labrynthitis?

Answer 15

Vertigo, loss of balance, nausea + vomiting, hearing is affected, head movement sensitivity

Question 16

Vestibular Neuritis is a vestibular crisis improving over

Answer 16

4 days

Question 17

Signs and symptoms of vestibular neuritis

Answer 17

head movement sensitivity, vertigo, nausea, note: hearing is NOT affected

Question 18

What are some useful outcome measures for vestibular disorders?

Answer 18

• Visual Analogue Scale (VAS)
• Activities Specific Balance Confidence Scale (ABC)
• Motion Sensitivity Quotient (MSQ)

Question 19

Some signs and symptoms of Benign Paroxysmal Positional Vertigo?

Answer 19

Vertigo, nausea, feeling off balance, motion sensitivity

Question 20

When and how long are episodes for BBPV lasting?

Answer 20

Acute (sudden onset) with spells lasting typically <1 minute

Question 21

What are some positions that may aggravate BPPV ?

Answer 21

Rolling over in bed, bending down, looking up