Vestibular Presentation Flashcards
MAV
- migraine associated vertigo
- 2nd most frequent cause of recurrent vertigo
- misaligned vertebrae messes with blood flow to brain, surrounding nerves vasodilate other arteries which irritates brain/vestibular structures
MAV Causes/Risk Factors
- hormonal fluctuations
- foods
- weather changes
- stress
- meds
- sleep disturbances
MAV S/Sx
- dizziness
- motion intolerance
- spontaneous vertigo attacks
- diminished eye focus
- photosensitivity
- sound sensitivity/tinnitus
- balance loss and ataxia
- neck pain with associated muscle spasms
- confusion, altered cognition
- spatial disorientation
- anxiety/panic
MAV Tests/measures
- audiologists
- vestibular rehab specialists
- computerized audiological/dynamic visual acuity testing
- horizontal canal testing
- functional balance/gait measures
- Jacobsen Dizziness Inventory
- Dynamic Gait Index
- ABC
- TUG
MAV Interventions
- Meds
- Vestibular Rehab
- Lifestyle mods
MAV Interventions
- Meds
- Vestibular Rehab
- Lifestyle mods
PPPD
- peripheral postural-persistant disorder
- comes with behavioral aspects (OCD, depression, Anxiety)
PPPD Cause/Risk Factors
- Environments (Crowds, stores, motion)
- medical illness
- previous/concurrent vestib disorder
- upright posture
- head/body motion
- after vertigo causing event
- drug reactions
PPPD S/Sx
3 or more months of:
- postural dizziness (no vertigo)
- unsteadiness that fluctuates
- rocking/swaying feeling
- more symptomatic days than not
- Sx with no particular movement
- behavioral attributes (anxiety etc)
PPPD Intervention
- meds
- vestibular balance rehab therapy
- counseling
Vestibular/Labyrinthitis Neuritis
-infection that inflames CN
VIII
Vestibular Neuritis S/Sx
- loss of balance
- affects vestibular branch of CN VIII
Labyrinthitis
- vestib and cochlear branches of CN VIII
- loss of hearing and balance
Risk Factors of labyrinthitis, vestib neuritis
- all age groups
- kids less
- viral infection (less likely bacterial)
S/Sx Labyrinthitis/Vestibular Neuritis
- vertigo
- dizziness
- disequilibrium
- imbalance
- nausea
- hearing loss (vestib)
- not painful
Labyrinthitis/Vestibular Neuritis:
Dizziness
- Acute: constant, sudden severe
- chronic: fast movement, persistent feeling of haziness/uneasiness
Acute Labyrinthitis/Vestibular Neuritis Treatment:
-meds to kill virus/bacteria
Chronic Labyrinthitis/Vestibular Neuritis:
- BPPV can develop (epley)
- vestibular rehab exercises
Perilymphatic Fistula
- membrane tear between middle ear and inner ear
- perilymph fluid from inner ear flows into middle ear
Perilymphatic Fistula
- membrane tear between middle ear and inner ear
- perilymph fluid from inner ear flows into middle ear
Causes of Perilymphatic Fistula
- head trauma
- whiplash
- ear trauma
- scuba diving
- rapid incr in ICP
Perilymphatic Fistula S/Sx
- ear feels full
- sensitive hearing
- dizziness (w/ or w/o vertigo)
- sudden hearing loss
- symptoms increase with change in altitude
- Sx with increased CSF pressure
Perilymphatic Fistula S/Sx
- ear feels full
- sensitive hearing
- dizziness (w/ or w/o vertigo)
- sudden hearing loss
- symptoms increase with change in altitude
- Sx with increased CSF pressure
Perilymphatic Fistula Treatment
- surgery
- post surgery: don’t perform activities that incr CSF
Meniere’s Disease
-Fluctuating vestibular condition that presents with acute episodes involving a variety of inner ear S/Sx following by mostly Sx free period between attacks
Causes of Meniere’s Disease
-endolymphatic hydrops
S/Sx Meniere’s Disease
- rotational vertigo attacks
- hearing loss
- tinnitus
- sensation of fullness or pressure
–imbalance, nystagmus, otolithic crisis of Tumarkin (falls) during attacks
Diagnosis of Meniere’s Disease
- hearing tests
- blood tests
- MRI
- Rule out other Dx
Treatment Meniere’s Disease
- no cure
- medications
- hydrops diet (maintain constant sodium levels)
- no PT during attacks
Tumors of Vestibular System
- most common is: vestibular schwannoma or acoustic neuroma
- men=women
- age 30-60
Causes of Vestibular Schwannoma
-over production of myelin from Schwann Cells of the Vestibulocochlear nerve
S/Sx of Vestibular Schwannoma
- unilateral hearing loss
- tinnitus
- dizziness
- loss of balance
S/Sx of Vestibular Schwannoma
- unilateral hearing loss
- tinnitus
- dizziness
- loss of balance
Dx of Vestibular Schwannoma
- audiogram
- CT
- MRI
Treatment of Vestibular Schwannoma
- surgical removal
- radiation
- careful monitoring of symptoms
