topic 8 - dizziness Flashcards
what is the positive outcome of physio management of the cervical spine and vestibular system following concussion
3.8x more likely to be medically cleared to RTS by 8 weeks compared to control
what are the potential causes of dizziness
vestibular
migraine
cervical
CNS (multiple areas of the brain involved in balance)
lack of blood flow / vascular event
psychogenic (secondary to primary dizziness disorder)
medication
what is the vestibulo ocular reflex (VOR)
responsible for maintaining stable vision during head motion
eye velocity = head velocity in the opposite direction
what is peripheral vestibular hypofunction
imbalance in input from peripheral vestibular to central vestibular or a differnence between the ears
imbalance and vertigo
nystagmus (acute)
approx 10% of dizziness
what happens to peripheral vestibular hypofunction over time
recovery or compensation
brain picks the systems that are working/giving the best info
what is the head thrust test
quick clinical test
slight nod with small rotations
unpredictable
what is a positive and negative head thrust test
negative
- eyes stay on target
positive
- corrective saccade observed towards the side of the thrust
- delay in eye mvmt with eyes moving with the head and correct back to focus point after mvmt
what is static visual acuity
lowest line read with the head still
what is dynamic visual acuity
lowest line read with head moving
(2Hz rotation to ensure use of VOR)
similar to behavioural head motion
sensitive to change and responsive ot rehab
what is benign paroxysmal positional vertigo (BBPV)
crystals in otolith are dislodged into the semi circular canals making them responsive to gravity
when they move into a plane affected by gravity - fluid stops but crystals continue and give the signal of continued motion
what is the benefit of the hall pike dix test
can be done with a neutral neck in cases of neck pain
what is the hall pike dix test
can move the patient into a position that causes a large amount of fluid flow in a canal
can test each canal (usually in posterior)
what is a positive hallpike dix test
reproduction of symptoms (vertigo) and nystagmus (usually brief and occurs at the same time as symptoms)
what does vestibular rehab work well for
BBPV
unilateral peripheral vestibular hypofunction
what can positive tests for dizziness, neck pain, ocular motor function be predictors of
PPCS
