Pathologies

Question 1

Three of the most common vestibular pathologies

Answer 1

BPPV, Labrynthitis/Neuritis, Meniere’s Disease

Question 2

Repetitive involuntary eye movements that may be torsional, horizontal, or vertical

Answer 2

Nystagmus

Question 3

A pathology characterized by sudden vertigo provoked by certain head movements

Answer 3

Benign Paroxysmal Positional Vertigo (BPPV)`

Question 4

BBPV occurs when

Answer 4

Some of the otoconia is displaced from the saccule or utricle and enters the SCC

Question 5

BPPV affects hearing thresholds in what way

Answer 5

Hearing is WNL or unchanged from prior thresholds

Question 6

BPPV that manifests in the horizontal canal can be diagnosed with the following test(s)

Answer 6

Dix Hallpike Maneuver, Roll Test, Bow and Lean Test, Case History

Question 7

BPPV that manifests in the anterior canal can be diagnosed with the following test(s)

Answer 7

Straight Head Hang, Deep Head Hang

Question 8

Otoconia which settles in the semicircular canals

Answer 8

Canalithiasis

Question 9

Otoconia which adheres to the cupula

Answer 9

Cupulothiasis

Question 10

When a BPPV patient experiences canalithiasis, their nystagmus is

Answer 10

Geotropic (beating towards the earth), with the problem ear down

Question 11

When otoconia is loose in the posterior SCC, nystagmus is

Answer 11

Torsional and up-beating

Question 12

When otoconia is loose in the lateral/horizontal SCC, nystagmus is

Answer 12

Horizontal

Question 13

When otoconia is loose in the superior SCC, nystagmus is

Answer 13

Torsional and down-beating

Question 14

Labrynthitis is caused by

Answer 14

An infection of the inner ear, nerves and bony labyrinth that affects both branches of CN VIII

Question 15

Labyrinthitis is typified by symptoms such as

Answer 15

Unilateral SNHL
Varying to poor speech discrimination scores
Sudden hearing loss
Sudden onset tinnitus
Sudden onset vertigo

Question 15

Neuritis is caused by

Answer 15

An infection of the inner ear, nerves and bony labyrinth that affects the vestibular portion of CN VIII

Question 16

Neuritis is typified by symptoms such as

Answer 16

Hearing WNL (or unchanged from previous hearing)
Sudden onset dizziness/vertigo
Tinnitus
Aural Fullness

Question 17

Describe Meniere’s Disease

Answer 17

Primary Idiopathic Endolymphatic Hydrops; an abnormal fluctuation of endolymphatic fluid, which causes an increase in pressure

Question 18

Meniere’s Disease is typified by symptoms such as

Answer 18

Aural Fullness
Tinnitus
Fluctuating Hearing Loss
Episodic Vertigo

Question 19

Episodes of Meniere’s Disease occur when

Answer 19

An increase of pressure in the endolymphatic duct
Can lead to a leak in the membrane in the membrane the separates endolymph and perilymph

Question 20

When endolymph (high in __ ) and perilymph (high in __ ), a sudden change in ______ along the vestibular nerve can lead to vertigo

Answer 20

Potassium, Sodium, firing rate

Question 21

Describe Vestibular Migraines

Answer 21

Diagnosed migraines accompanied by at least 5 episodes of vestibular symptoms (dizziness, imbalance, vertigo) lasting between 5 minutes and 72 hours

Question 22

Vestibular Migraines are typified by symptoms such as

Answer 22

Hearing WNL or no change in hearing acuity
Moderate to severe head pain (throbbing or pulsing)
Dizziness
Sensitivity to light or sound
Nausea/vomiting

Question 23

Describe acoustic neuromas

Answer 23

Benign slow growing tumor on the vestibular portion of CN VIII
Caused by an overproduction of Schwann cells (vestibular schwanomma)

Question 24

Acoustic neuromas are typified by symptoms such as

Answer 24

Asymmetries on the audiogram Positive contralateral acoustic relfex decay Absent relfexes despite normal hearing Asymmetrical WRS Dizziness Unilateral tinnitus Unilateral aural fullness

Question 25

Describe a semicircular canal dehissance

Answer 25

Hole in the bone covering the superior semicircular canal, creating a third window Endolymph moves in relation to sound or pressure changes, triggering a vestibular response

Question 26

SCD's are typified by symptoms such as

Answer 26

Low frequency conductive hearing loss Type A tymps Dizziness Tullio's phenomenon Oscillopsia Autophony

Question 27

Tullio's phenomenon

Answer 27

Dizziness induced by sounds

Question 28

Oscillopsia

Answer 28

Visual disturbance where still objects appear as if they moving back and forth/up and down

Question 29

Autophony

Answer 29

Hearing your own voice or breathing in your ear

Question 30

Describe an Enlarged Vestibular Aqueduct

Answer 30

Inner ear malformation resulting in SNHL Congenital, typically caught in childhood Sometimes triggered by head trauma

Question 31

EVA is typified by symptoms such as

Answer 31

Hearing loss (conductive, SNHL, or mixed) Dizziness (vertigo or imbalance)

Question 32

Describe Mal de Barquement

Answer 32

"Sickness of deembarkment" Imbalance caused by exposure to unfamiliar movement followed by an inability to calibrate once movement is normal Sensation of still being on a boat after a cruise for example