Term
| What the most common peripheral vestibular disorder? How many cases are there per year? |
|
Definition
| Benign Paroxysmal Positional Vertigo (BPPV); 64,000-100,000 cases/year |
|
|
Term
| What is the frequency of BPPV based on these ages: 11-29, 30-59, and 60-99 years of age? |
|
Definition
|
|
Term
| What are the 5 typical movements which provoke symptoms of BPPV? |
|
Definition
| Bending over, looking up, lying down or getting up, rolling over, or going to salon or dentist. |
|
|
Term
| Between __-__% of patients with BPPV demonstrate a peripheral vestibulopathy |
|
Definition
|
|
Term
| ___ means the Otoconia attached or resting on cupula |
|
Definition
|
|
Term
| ___ means the Otoconia is floating within canal |
|
Definition
|
|
Term
-When the horizontal canal is stimulate you get a ___ nystagmus
-When you stimuluate the posterior canal, you get a ______ nystagmus
-When you stimulate the anterior canal you can get a _____ nystagmus |
|
Definition
-horizontal
-rightward torsional (upbeating)
-rightward tortional/downbeating
[image] |
|
|
Term
| What are the positional test positions? |
|
Definition
| Supine with head raised to 30 degrees, head right, head left, body right, and body left |
|
|
Term
-Positional testing is thought to provoke ___ VOR
activity in cases where the otolith system of the lesioned ear is closest to the ___
-Maybe related to something going on in the ___ canal.
-May also be produced by ___ issues |
|
Definition
| abnormal; ground; horizontal; CNS |
|
|
Term
Interpretation of Positional Nystagmus for Peripheral:
-Direction fixed ___ or ___ nystagmus
-___ with fixation (except for BPPV)
-Fast phase usually toward ___ ear except for: Irritative nystagmus, recovery nystagmus, HC- BPPV
-___ dynamically post head shake
-May not be ___ within position |
|
Definition
-horizontal; torsional
-Suppression
-intact
-Enhances
-persistent |
|
|
Term
| Interpretation of Positional Nystagmus for Central: -___ nystagmus (up or down beating) -_____ with fixation -___ (away from earth) with or without subjective dizziness -May be caused by: ___, tobacco, ___ -_____ dynamically; usually ___ while in position |
|
Definition
| Vertical; No suppression; geotropical; pharmacy; alcohol; Does not enhance; persists |
|
|
Term
Pathophysiologic Process of BPPV:
-Displaced ___ are present as mobile densities within the canal (usually posterior)
-After a ___ ___ the mass of otoconia moves within the SCC
-The movement displaces ___ fluid, deflecting the ___ of the involved canal and eliciting nystagmus and vertigo |
|
Definition
| otoconia; head movement; endolymphatic; cupula |
|
|
Term
| What percentages of cases has a posterior canal cause? Horizontal canal? Anterior canal? |
|
Definition
-posterior=61-97%
-Horizontal=1-32%
-Anterior=0-21% (controversial; not sure if this really occurs) |
|
|
Term
| Describe the semont manueuver. What canal does it target? |
|
Definition
| It targets the posterior canal. Sit on edge of bed and turn head 45 degrees to the right and quickly lay on the side for 1 min and then quickly switch to the left side without moving your head. Lay there for one minute. |
|
|
Term
| Describe the Epley manueuver. What canal does it target? |
|
Definition
| It targets the posterior canal. Lay patient down like the dix-hallpike and lay the patient down on the affected side until nystagmus starts and until it stops and then double that time. Then move the patients head quickly to the other side and do the same thing. Then have patient role onto that side of the body and have them look at the floor. |
|
|
Term
| Describe the modified epley manueuver. What canal does it target? |
|
Definition
| It targets the posterior canal. Lay on the affected side and then skip the supine position and have the patient role onto the opposite side and have the patient look at the floor. Then have the patient sit up. Use on patients who can't lay on their back. |
|
|
Term
| Describe the Gans Repositioning manueuver. What canal does it target? |
|
Definition
| It targets the posterior canal. Lay patient down on the side of the affected ear and then have patient switch 90 degrees to the unaffected ear and stay and role on the side and then do a head shake. |
|
|
Term
| Describe the BBQ roll/log roll manueuver. What canal does it target? |
|
Definition
| It targets the horizontal canal. " Have the patient slowly lay down in the supine position, then roll to affected side, then roll back to supine position, then role to the unaffected ear, then roll onto your elbows with your chin tucked in, and then role back on the affected side |
|
|
Term
| Describe the gufoni manueuver. What canal does it target? |
|
Definition
| It targets the horizontal canal. Starts with the patient seated and then they are quickly moved to lie on their side for the unaffected side. After 2 minutues (or wait for nystagmus to stop and then double that time), their head is turned 45 degrees towards the ground and kept in that position for another 2 minutes ("). The patient is then sat up. |
|
|
Term
| Describe the appiani manueuver. What canal does it target? |
|
Definition
| It targets the horizontal canal. Same as Gufoni procedure except that you lean to the affected ear side and access for any nystagmus that may be present while the patient is looking at your nose. This is just to make sure that the otolith is in the posterior portion of the horizontal canal. |
|
|
