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Vestibular

Terms in this set (31)

-neck pain and headache
-disequilibrium and dizziness
-whiplash and other soft tissue injury
cervicogenic dizziness
Treatment for cerivcogenic dizziness
-test vertebrobasilar A -if +, refer
-tx cervical spine
-balance and gt training
-gaze stabilization
Pt admitted to ER for sudden onset of severe dizzi
...
-inflammation of semicircular canals, vestibule, or labyrinth
-vertigo/dizziness
-impaired vision (VOR)
-usually unilateral and sudden onset
-hearing problems
labyrinthitis
-dizziness/vertigo
-impaired vision
-hearing intact
-inflammation of vestibular portion of CN VIII
-usually unilateral and sudden onset
Neuritis
PT intervention for labyrinthitis and neuritis
-get pt off meclizine
-challange vestibular system
-hearing loss
-vertigo
-fullness in ear
-tinnitus
-recurrent/ episodic
Meniere's
PT for Meniere's
-none in acute flare up
-balance retraining after
-edu on low salt diet, and other triggers
-cause is often a traumatic event
-dizziness
-ear fullness
-motion intolerance
-general ill-feeling and headache
perilymphatic fistula
Tx for perilymphatic fistula
-best rest
-PT contraindicated unless ongoing imbalance or post-op vestibular hypo-function
-varied sx's
-unilateral headache and severe pain
-light or noise sensitivity
-N/v, dizziness, imbalance
vestibular migraine
treatment for vestibular migrane
-PT: vestibular rehab
-neurologist
-migraine mgmt w/ meds and diet
-find triggers and reduce
-hearing loss is often 1st sign
-vertigo/imbalance
-facial sx's
Vestibular Schwannoma
(acoustic neuroma)
acoustic neuroma treatment
-surgery
-PT right after --> reduce imbalance and oscillopsia (tx for UVH)
-gaze stabilization exercise to induce retinal slip and specificity of training
-good for unilateral peripheral and incomplete bilateral dysfunction
Adaptation
-improve pt's ability to use other sensory systems and central pre-programming
-stress system by reducing sensory cues
-train to pay attention to feedback from other systems
-use if no remaining vestibular function
Substitution
-for pts with motion sensitivity
-suppression of vertigo thru repetitive provoking movements
-takes wks-mo
-MSQ
-not for all pts
Habituation
-when other approaches ineffective
-ADs
-extra lighting or hand on wall
-alter environment
Compensation
Tx for UVH
-adaptation
-x1 and x2
-normalize/ improve balance
-challenge balance
Tx for BVH
-substitution and compensation
-imaginary objects
-horizontal targets
-x1
-balance and safety edu
Central disorder: acute cerebellar stroke
-adaptation
-x1 and x2
-balance retraining
central disorder: MS
-compensation and substitution
Epley cures which BPPV?
canalithiasis
Semont (Liberatory) cures which BPPV?
cupuloiathiasis
BBQ roll cures which BPPV?
horizontal canal
optimal exercise for acute/subacute?
3x/day, for at least 12 min
optimal exercise for chronic?
3x/day, at least 20 min per day
-gaze and postural instability
-impaired VOR
-nystagmus
-vertigo/dizziness with head/body motion
-diminshed dynamic balance esp in crowded environment
unilateral peripheral hypofunction
-oscillopsia
-ataxic gt and severe imbalance
-sensitive to motion in environment
bilateral peripheral hypofunction
-resting nystagmus
-impaired balance
-if brainstem near vestibular nuclei - UVH
-cortical - more post-stroke
central vestibular disorder
-brief episodes of vertigo with changes in head position
-nausea
-nystagmus
BPPV
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