Vestibular Disorders Flashcards
Dizziness
A vague term to describe a range of sensations such as lightheadness, faintness, whirling, or unsteadiness
Vertigo
An illusion of movement
- A sensation of rotation or movement of one’s self (subjective vertigo) or of one’s surroundings (objective vertigo) in any plane
- Likely a vestibular dysfunction
Lightheadness / Presyncope
A feeling that fainting may occur or is about to occur
“nearly blacking out” or “nearly fainting”
- Lasts seconds to minutes
- Nothing in the vestibular system to cause LOC - cardiology
Hypotension (orthostatic),hypoglycemia, axienty (hyperventilation), cardiac arrthythmias
Dysequilibrium
Sensation of being off balance - feeling of imbalance
Gait Disequilibrium
- Feel normal other than on feet
- Peripheral neuropathy (DEC sensation), cerebellar, motor control problems (neurological)
Global Disequilibrium
- A pervasive feeling of imbalance
- Feeling woozy with any movement at all
- Potentially vestibular dysfunction
Oscillopsia
Subjective experience of objects moving in the visual environment that are known to be stationary
- May occur with head movements in patients with vestibular hypofunction (poor gaze stabilization)
Nystagmus
Rhythmic eye movement (most often involuntary)
Bengin Paroxysmal Positional Vertigo (BPPV)
A biomechanical disorder of the inner ear in which the octonia (calcium carbonate crystals) is displaced from the urticle into the semicircular canals
Most common cause of vertigo
BPPV: S/S
Occurs only with changes in head position
- Nystagmus with change
- Vertigo with change
- Nausea w/ or w/o vomitting
- Disequilibrum
Duration of symptoms typically less than 60 seconds
BPPV: Special Tests
Name & (+)
Dix-Hallpike Test
(+) patient presents with nystagmus
* Direction & duration of the nystagmus can help determine whether the patient has semi-circular canal (SCC) BPPV or a central lesion
Roll Test
(+) patient presents with nystagmus or vertigo
* Indicates horizontal semi-circular canal (SCC) BPPV
BPPV: Interventions
Canalith Repositioning Manuever (Epley Manuever)
- Patients head is moved into different positions in a specific sequence to move the debris out of the involved SCC and into the vestibles (urticle & saccule)
- May be used for posterior or horizontal SCC BPPV
The Liberatory (Semont) Manuever
- Patient rapidly moves through positions designed to dislodge the debris from the cupula
- May be used for cupulolithiases
Brandt-Daroff exercises
- Patient rapidly moves through positions designed to dislodge debris from the cupula or move debris out of canal
- Exercises should be performed 5-10 reps, 3x/day until symptoms have resolved for 2 consecutive days
Unilateral Vestibular Hypofunction
A condition in which one of the peripheral vestibular receptors or the vestibulocochlear nerve (CNVIII) is functioning improperly
May be d/t:
- infection
- trauma
- vascular events
- Meniere’s disease
UVH: S/S
(5)
- Vertigo
- Oscillopsoa during head movements
- Spontaneous nystagmus
- Postural instbaility
- Dysequilibrium
UVH: Goals / Interventions
- Improve gaze stability during head movements
VOR training - Improve static and dynamic postural stability
Postural stability exercises - DEC sensitivity to motion
Habituation exercises (motion sensitivity)
Meniere’s Disease
An inner ear disorder that can lead to low-frequency hearing loss and episodic vertigo
- Chronic Meniere’s disease may lead to UVH
Pathophysiology in part is d/t an abnormal amount of endolymph fluid collecting in the inner ear
Meniere’s Disease: S/S
(4)
- Low frequency hearing loss
- Episodic vertigo
- Aural fullness
- Tinnitus
