Vestibular Function Testing

Question 1

What is vertigo

Answer 1

The illusion of movement of self or world- often spinning
Typically discrete episodes
Normally suggest peripheral vestibular involvement

Question 2

What is imbalance, lightheadedness, unsteadiness

Answer 2

-history more vague
-less likely to be discrete episodes
-central cause may be more likely- particularly if symptoms appear to be deteriorating

Question 3

Consequences of long term dizziness

Answer 3

• Tiredness
• Headaches
• Time off work and financial consequences
• Inability to perform at full potential at work.
• Inability to contribute to home life fully.
• Anxiety
• Depression
• Patient education and correct intervention will help:
• Reassure patient
• Prevent turning into a crohnic problem

Question 4

Otolith organ function

Answer 4

Linear acceleration and static tilt/gravity

Question 5

Semi circular canals

Answer 5

Angular acceleration in three planes

Question 6

How does the vestibular system work in terms of semi circular canals

Answer 6

Movement of head>endolymph>cupola deflection>hair cell deflection> action potential up nerve

Question 7

How does the vestibular system work in terms of otoliths organs

Answer 7

Movement of head> shearing force on hair cells due to heavy otolithic membrane> hair cell deflection> action potential up nerve

Question 8

What happens when there is head movement in terms of balance

Answer 8

• Head movement initiates vestibular reflexes to keep eyes stable in space to help maintain upright posture.

Question 9

What does the vestibuloocular reflex do

Answer 9

Helps eyes stay on target when moving around
Automatic

Question 10

What does the vestibulospinal relflex do

Answer 10

Body balance

Question 11

What does the vestibulocollic reflex do

Answer 11

Neck balance

Question 12

What is vestibular neuritis

Answer 12

Function of one balance organ drops
Acute spinning 48 hours, movement evoked imbalance

Question 13

Labryinthitis

Answer 13

Function of one balance organ drops and unilateral hearing loss
Acute spinning 48 hours, movement evoked imbalance, hearing difficulties

Question 14

Bilateral hypo function

Answer 14

Function of both balance organs can drop
Loss of balance, oscillopsia, movement evoked imbalance

Question 15

Benign paroxysmal positional vertigo

Answer 15

Otoconica moves from utricle into posterior semi circular canal

Question 16

Menieres

Answer 16

Short lived spinning on rolling in bed, looking up and bending down
Increased endolymph pressure

Question 17

Migraine associated dizziness

Answer 17

Episodic bouts of spinning for up to 24 hours, unilateral drop in hearing, tinnitus and fullness
Migraine symptoms and dizziness

Question 18

What does testing often look at

Answer 18

Vestibulo ocular reflex
Ie looking at eye movement in response to testing

Question 19

What is eye movements called

Answer 19

Nystagmus

Question 20

What are some of the simple tests that can be done

Answer 20

Head impulse test
Dix hall pike

Question 21

Tests with equipment

Answer 21

• videonystabmography
• calorics
• video head impulse

Question 22

More advanced tests

Answer 22

• vestibular evoked myogenic potentials
  -rotating chair
  -posturography (high tech test of standing balance)