Disorders of the Vestibular Systems Flashcards
(25 cards)
What does BPPV stand for?
Benign Paroxysmal Positional Vertigo
What are some of the signs/symptoms that will be seen with BBPV?
Vertigo with rapid changes in head positions (usually rapid extension often with head turn)
Short lived vertigo (30 s - 2 minutes)
Complain of mild postural instability after flareup
What will NOT be seen with BPPV?
Loss of hearing (if present look at other considerations), “fullness of ear”, and tinnitus
Who is more likely to have BPPV: Nicole or Clint?
Nicole
Even though BBPV is USUALLY unilateral it can be bilateral in two instances. What are they?
1) Spontaneous cases (10%)
2) Traumatic -TBI especially (20%)
Is this self limiting?
Usually yes, within 6-12 months. May last off and on for years though.
Name the test that you would use to evaluate BPPV.
Dix-Hallpike; Test is positive if vertigo and nystagmus occurs. (Use Frenzel glasses to make eye monitoring easier)
What is Cupulolithiasis?
One of the theories of BPPV. Says that the deposition of otoconial material on the cupula makes the cupula denser than endolymph which makes it susceptible to gravity.
What is the name of the other theory behind BPPV?
Canalithiasis; says that debris with higher density that endolymph is free floating in the canal. When the head moves the debris sinks to the lowest part and cause the endolymph and deflect the cupula.
Describe Vestibular Neuritis.
Unknown etiology, but probably viral.
Normally a tonic and equal activity from the vestibular apparatus on both sides, but in this condition activity is lost from one side.
What are the S/S of vestibular neuritis?
Acute onset of prolonged, severe rotational vertigo
Imbalance, nausea, nystagmus toward good ear, hearing loss NOT usually associated.
What is caloric testing?
Squirt hot/cold water past the inner ear. usually find its hypo functional on that side (horizontal canal paresis)
Recovery from Vestibular Neuritis is attributed to what?
1) Central compensation of vestibular tone balance (helped by accommodation/habituation exercises)
2) Peripheral restoration of labyrinthine function.
What is the term for complete deafferentation or destruction of a labyrinth caused by vestibular neuritis, medications, or surgery?
Unilateral Vestibular Deafferentation Syndrome
There are three stages of Meniere’s Disease. Name the first one.
Initial Stage: characterized by “fullness” in the ear, tinnitus, or hearing loss.
After a few minutes the next stage of Meniere’s starts. What happening during the 2nd stage and how long does it last?
Lasts 30 min-24 hours.
Severe rotational vertigo, postural imbalance, and nausea and vomiting.
The worst of the symptoms for Meniere’s abate in __ and the person is up and walking in ______.
24 hours, 2-3 days
True or false: Normal balance will return after a Meniere’s attack.
True, instability can persist for days or weeks, but normal balance will return.
True or false: Normal hearing will always come back.
False: hearing may return to normal, but it could also be partially lost. Tinnitus may disappear or persist.
True or False: Attacks will decrease in the first year.
False: They typically increase the first year and then decrease.
Are the attacks more often unilateral or bilateral?
Usually unilateral, but can be bilateral
What is the pathophysiology of Menieres?
Unknown etiology, result is an increase in endolymphatic fluid pressure within the inner ear (results in dissension of otolith organs and ampulla) {called endolymphatic hydrops}
Treatment for Meniere’s includes what?
No known PT interventions, treatment is completely medical. Can treat balance issues after they go into remission
What are some of the causes of Bilateral Vestibular Disorders?
Meningitis, labyrinthine infections, Paget’s disease, bilateral tumors (acoustic neuromas associated with neurofibramotosis), meds, autoimmune disorders, etc.
