vestibular

Question 1

compare canalthiasis v cupulolithiasis

Answer 1

canalthiasis
- short duration, less than 1 min

cupulolithiasis
- persistant in duration, more than 1 min

cupuLOlithiasis - LOnger

Question 2

upbeating torsional nystagmus

Answer 2

posterior canal

PUP: posterior upward

Question 3

downbeating torsional nystagmus

Answer 3

anterior canal

Question 4

intervention for treating canalilithiasis

Answer 4

eply or canal repositioning manuever, CRM

Question 5

intervention for treating cupulolithiasis

Answer 5

semont or liberatory

this is the only intervention where you position the head on the non-affected side

Question 6

what intervention do you do when your pt cannot tolerate CRM

Answer 6

brandt daroff exercise

Question 7

what position explain is the neck when performing supine roll test

Answer 7

neck flexed to 20deg

Question 8

geotropic v apogeotropic

Answer 8

geotropic
- towards ground
- canalithiasis
(towards ground; ground has canals)

~ the side that is more intense is the affected side

apogeotropic
- away from ground
- cupulolithiasis

~ the side that is less intense is the affected side

Question 9

intervention for horizontal BPPV

Answer 9

BBQ roll

Question 10

if someone is presenting with abnormal smooth pursuits and saccades, what do you do

Answer 10

central vestibular pathology - refer out

Question 11

with someone with BPPV, is their VOR intact or not?

Answer 11

yes, its intact

Question 12

compare central v peripheral vestibular pathology

Answer 12

central:
- ataxia
- abnormal smooth pursuits and saccades
- diplopia and other red flags (difficulty swallowing)
- usually no hearing loss (intact)
- pendular nystagmus
- persistant vertical nystagmus
- visual fixation does not improve

peripheral
- no ataxia, if so, very mild
- normal smoot pusuits and saccades
- hearing loss, fullness in ears, tinnitus
- nystagmus
- symptoms improve

Question 13

labyrinthitis

Answer 13

inflammation of the labyrinth
sudden onset of vertigo, n/v
(+) head impulse test
duration: days to weeks

hearing loss, tinnitus

Question 14

vestibular neuritis

Answer 14

inflammation of the nerve
sudden onset of vertigo, n/v
(+) head impulse test
duration: days to weeks

Question 15

meniere’s disease

Answer 15

overproduction of fluid within the inner ear - increases pressure = vertigo

symptoms:
vertigo
hearing loss
tinnitus
aural fullness

duration: mintues to hours

Question 16

acoustic neuroma/vestibular schwannoma

Answer 16

slow developing tumor that develops from the balance and hearing nerves supplying the inner ear
- hearing loss
- tinnitus
- loss of balance
- vertigo
- facial numbess and weakness or loss of mm movement

Question 17

unilateral vestibular hypofunction

Answer 17

balance system in inner ear, the peripheral vestibular system is not working properly

• resting (spontaneous) nystagmus
• oscillopsia
• disequilibrium
• postural instability
• romberg:
  acute: (+)
  chronis: (-)

they have a WIDE BOS