Tests for Vestibular Flashcards
positive weber test
sound lateralizes positive for ipsilateal conductive loss
contralateral sensorineural loss
positive rinne test
helps further confirm conductive loss
1st degree of alexanders law
only present when gaze directed towards fast phase
2nd degree of alexanders law
present in primary gaze and when directed towards fast phase
strongest in fast phase
3rd degree alexanders law
present in all gazes
strongest in fast phase
optokinetic nystagmus
involuntary nystagmus
works synergistically with VOR
normal function should cause nystagmus
VOR testing
passively moving pt through horizontal canals at 30 deg below horizontal while maintaining gaze at nose
abnormal findings of VOR testing
corrective saccade
nystagmus
head thrust / head impulse test abnormal response
corrective saccade and/or post-thrust nystagmus
when is sensitivity at max with the head thrust/head impulse test
unpredictable head thrusts
fq >2Hz and velocity of >180 deg/sec
maintaining head positioning 30 deg below neutral
head shake test steps
fixation removed (close eyes)
120 bpm head shaking horizontal for 20s
keep eyes closed, therapist passively opens one eye and assess nystagmus
abnormal result for head shake test
> 3 beats of nystagmus considered significant for unilateral vestibular dysfunction
horizontal nystagmus beating away from involved ear
if you see vertical nystagmus following head shake test, what does that mean
central vestibular pathology
dynamic visual acuity is what
functional challenge to VOR
obtain baseline
2 cycles/sec
horizontal and vertical fields
what is the DVA better able to identify
dysfunction in subacute and chronic vestibular disorder
DVA results
> 3 line degradation is significant
what does skew deviation assess for
vertical dysconjugate gaze
what is skew deviation predictor for
central vestibular path
skew deviation abnormal response
deviation of one eye while it is being covered, followed by correction after uncovering it
VOR evaluates what
cerebellar control
abnormal results of VOR cancellation
ipsi corrective saccades
what are the three tests involved in HINTS
head impulse test
nystagmus observation
test of skew
what is the HINTS test used for
acute vestibular symptoms
what does INFARCT stand for
for CNS Dx:
impulse
negative
fast phase
alternates
repositions with
cover
test
the clinical test of sensory organization and balance is what
assess sensory contributions to postural control
involves observation of pt’s attempt to maintain balance
CTSIB 6 conditions
firm, eyes open (E, S, V)
firm, eyes closed (S, V)
firm, visual conflict (S, V)
foam, eyes open (E, V)
foam, eyes closed (V)
foam, visual conflict (V)
gans sensory organization performance test
modified romberg
CTSIB
fakuda step test
fakuda step test
50 steps eyes closed
moves 0.5m or 30 deg = uncompensated peripheral vestibular dysfunction
mini BESTest
observing anticipatory and reactive control, sensory organization and dynamic gait
MCID of minibest
4
BESS test
initially concussions and return to play - vestibular dysfunction
6 conditons, eyes closed for all, 20 seconds
measuring # of errors - max 10
BESS test MCID
3
computerized posturography: sensory organization testing
manipulate diff balance inputs to see how much person relies on
identifies malingering pt’s
computerized posturography: sensory organization testing levels
fixed support: normal vision, absent vision, sway vision
sway reference support: normal vision, absent vision, sway vision
