Vestibular Flashcards

1
Q

Common cause for Bilateral Vestibular hypofunction

A

ototoxic agents like gentamicin, PVH also

BL Meniere’s disease
trauma, autoimminune, neurodegenerative, alchohol

*pathologic, not just positional like BPOPV

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2
Q

Describe oscillopsia

A

Sensation of moving objects (oscillating)
Usually BL pathology

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3
Q

Diff between unilateral and BL vestibular hypofunction

A

UVH - vertigo and nystagmus due to imbalance between two sides

BVH - Typically not vertigo, nystagmus b/c balanced pathology, but there is disequilibrium, oscillopsia, instability with posture/gait

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4
Q

What is a diagnostic test for posterior canal BPPV

A

Dix Hallpike is the test
Epleys Maneuver is treatment

No saccades or smooth pursuit issues

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5
Q

What is diagnostic test and treatment for horizontal canal BPPV

A

Supine roll is the test
Barbecue roll is the manuever

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6
Q

What are some signs of a central lesion

A

Pure ubeating or downbeating nystagmus, wide BOS, direction-changing nystagmus, catch up saccades,

abnormal smooth pursuits b/c coordination of eyes not intact

Pendular nystagmus (equal speeds)

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7
Q

Interventions for central lesions

A

balance training, gaze stabilization exercises, etc.

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8
Q

Interventions for UVH

A

Habituation training, balance training,
Amount of training is 1-2 times per week
Greater amount of weeks for BL or chronic vs UL acute

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9
Q

Signs of peripheral lesion (general)

A

Slow and fast paced jerk nystagmus (not equal speed)

normal smooth pursuit and saccades because coordination of eyes intact

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10
Q

Wha is an abnormal saccade

A

inaccurate, jerky too fast or too slow when looking back and fourth

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11
Q

What is an abnormal smooth pursuit

A

Cant follow moving target

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12
Q

Unilateral hypofunction causes

A

Menieres disease, trauma, surgery, ototoxic medication

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13
Q

Push pull relationship

A

corresponding planes on one side vs the other. One side is excited while the other is inhibited

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14
Q

VOR

A

Vestibular Ocular Reflex

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15
Q

VSR

A

Vestibular spinal reflex

controlled by vestibulospinal tracts and reticulospinal tracts

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16
Q

Vertigo is

A

Mismatch between vestibular inputs and the expected based on movement completed

17
Q

Peripheral dx

A

unilateral, BL hypofunctions, BPPV, Menieres

18
Q

BPPV diagnostic criteria

A

1-2 second latency, then increases early on, lasts 30 sec to 2 min, will go away after precipitating positon maintained

Movement provoked,

19
Q

Dix hallpike steps and results

A

Sitting turn head 45 degrees to affected side
Bring down to supine with head into 30 ext off table
Hold 1 - 2 min

Confirmed w/ upbeat torsional and slight horizontal, fast beating

20
Q

Canalithiasis vs cupulithiasis (stuck)

A

Key difference
The canal has latency and set time 30 sec to 2 min
cupulo (octonia stuck) so NO latency and stays until position is changes because it is stuck

21
Q

Menieres Disease

A

Starts with fullness of the ear, tinnitus, loss of hearing, then UVH symptoms

Intervention: MEDS, no vestibular exercisers in acute phase.

22
Q

Geotropic

A

nystagmus beats towards ground due to canalisthesis

ageotropic for cupolo

23
Q

For PSSC

A

Brandt-Daroff exercises for pSCC BPPV
▪ Primarily used for BPPV
desensitization
▪ “Originally designed to habituate
the CNS to the provoking position”
▪ “…not effective to remove
displaced otoconia.

24
Q

Semont liberatory specifically for

A

BPPV cupulo

25
Q

Epleys for

A

BPPV canal

26
Q

VOR cancellation

A

VOR Cancellation
▪ Compensatory vestibular desensitization
exercise
▪ This treatment is done to remedy unilateral
vestibular hypofunction (vestibular neuroma,
neuritis, infection, etc.)

Test basically is for cerebllum. Can eyes stay on target