Anatomy
What are the Otolith Organs
Utricle and saccule
This term describes the sensation that the room/ world is spinnig
Vertigo
This test must be performed before anything to assess for VBI
VAT or MVAT
Cuplolithiasis latency period lasts how long
there is no latency period
55 year old complains of dizziness when rolling in bed-what test would you perform
Roll Test
what is the name of the crystals found in the inner ear
This condition is associated with drop in BP by at least 20mmHg when standing from supine
Orthostatic Hypotension
Name positive mVAT symptoms
Dizziness, drop attacks, disequilibrium, diplopia, & dysarthria
How long do canalithiasis symptoms last
Less than 60 seconds
55 year old complains of dizziness when rolling in bed. During Rolling Test he shows geotropic nystagmus bilaterally. On the left side, the nystagmus is stronger and fatigues in under 50 seconds after short delay
Left horizontal canalithiasis
What is the artery that supplies the inner ear
Labyrinthine artery
What is the tempo for BPPV
Chronic Seconds
3rd degree gaze evoked nystagmus is seen in how many gaze positions
all 3 positions
This positional test assesses for horizontal canal BPPV and looks for geotropic or apogeotropic nystagmus
Roll Test
PT performs a Right Dix Hallpike and you observe upbeating Right torsional nystagmus and latency period of less that 60 sec, which canal is involved
R posterior vertical canalithiasis
What are the neurologic pathways for visual input
Dieter's tract & medial longitudinal Fasiculus (MLF)
Name 2 Examples of Peripheral Vestibular disorders
UVH/UVL, BVH/BVL, Motion sensitivity, BPPV, Labyrinthitis or vestibular neuritis
This test checks for unilateral or bilateral vestibular hypofunction by rapidly turning the head while maintaining gaze on a target
Head impulse test (HIT)
You have a positive roll test for R canalithiasis - will you see strong or weak nystagmus on the LEFT side
weak nystagmus
68 Year old presents on gaze- evoked nystagmus in all 3 directions. She also reports some imbalance and mild dysarthria. Is this a CNS, Peripheral, or
CNS
Where is the Vestibular Nuclear Complex located?
This condition worsens when still and improves with passive motion; often follows boat or cruise travel
Mal Debarquement
A positive test of Gaze Evoked Nystagmus
greatest nystagmus when looking away from involved side
After performing roll test you noticed no latency period and weak nystagmus on the left- what is the involved side.
Left side - cupulolithiasis
A 47 y/o reports of feeling off-balance when walking in the dark. She denies vertigo or lightheadedness and reports getting over an infection 1 week ago. HIT is positive bilaterally and she has difficult with gait when performing Heel-to-toe walking. Smooth pursuit are normal.
BVH