nystagmus

Question 1

Debris in Right Posterior semicircular canal results in what direction nystagmus and ocular torsion?

Answer 1

transient upbeating nystagmus and/or right ocular torsion

Question 2

Debris in Right Superior semicircular canal results in what direction nystagmus and ocular torsion?

Answer 2

persistent downbeating nystagmus and/or right ocular torsion

Question 3

Debris in Left Posterior semicircular canal results in what direction nystagmus and ocular torsion?

Answer 3

transient upbeating nystagmus and/or left ocular torsion

Question 4

Debris in left superior semicircular canal results in what direction nystagmus and ocular torsion?

Answer 4

persistent downbeating nystagmus and/or left ocular torsion

Question 5

symptoms of vestibular disorder

Answer 5

• Nystagmus
• Instability, ataxia, falls
• Dizziness, Vertigo
• Visual changes

Question 6

causes of vestibular disorders

Answer 6

• Trauma eg. TBI, post-concussion
• Neuronitis
• Meniere’s disease (edema of membranous labyrinth)
• Benign Paroxysmal Positional Vertigo (BPPV)
• Acoustic Neuroma

Question 7

what is meniere’s disease

Answer 7

• disorder of the inner ear
• usually unilateral
• symptoms - that can lead to dizzy spells (vertigo) and hearing loss
• usually starts between young and middle-aged adulthood
• chronic condition
• treatments can help relieve symptoms and minimize the long-term impact on your life

Question 8

most important first part of vestibular exam

Answer 8

Detailed History

Question 9

parts of vestibular exam

Answer 9

• Detailed History/Review of Systems
• Nature, duration, aggravating/alleviating postures
• Vestibulo-Ocular Reflex (VOR) testing
• Dix-HallpikeTest
Note: keep wastebasket nearby for vomiting

Question 10

how to do dix hallpike? purpose?

Answer 10

test posterior canal, side you are rotated toward

Sit to supine with neck extended and rotated 45 degrees towards side testing

Question 11

characteristics of PNS vestibular issue

Answer 11

• Resolves shortly (minutes to hours)
• Abnormal horizontal head impulse test
• Classic nystagmus (fast/slow phase)
• Normal smooth pursuit/saccade

Question 12

characteristics of CNS vestibular issue

Answer 12

• Diplopia > 2 weeks
• “Skew” deviation
• Pure vertical up beating nystagmus
• Hearing loss
• Oscillating nystagmus
• Abnormal smooth pursuit/saccade

Question 13

geotropic vs ageotropic

Answer 13

geotrophic- towards the ground,

ageotrophic is away from the ground (ceiling)

Question 14

Bilateral Vestibular Hypofunction - symptoms NO DOG

Answer 14

N- No nausea
O- ototoxicity
D- disequilibrium 
O- oscillopsia
G- gait ataxia