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Vestibular Disorders (Common Disorders/Causes (Comorbid disorders…

- - - - Dix-Hallpike Maneuver
        
        Let the head hang and rotated 45 degrees; look for nystagmus that fatigues within 60 sec
  - - - Usually affect vestibular nerve unilaterally
      - Onset often proceeded by viral illness
      - Ramsay Hunt syndrome - affects 7th and 8th cranial nerves
      - Unilateral vestibular neuronitis causes sudden vertigo, nystagmus, nausea, followed by intense disequilbirium
      - Medical Managament
        
        VOR becomes abnromal
        
        Treat w/medications ie. antihistamines, steroid, antivirals, glucocorticoids
        
        Symptoms typically resolve within 3 months, but there may be persistent vestibular complaints
  - - - vertebrobasilar insufficiency
    - - symptoms must be moderate to severe between 5 min to 72 hours
    - - infection affecting older people with diabetes or immunosuppression - puts pressure on facial nerve
        
        Most common complication is extradural abscess, fluid between dura mater and bone of the middle/post fossa - spread of infeciton can lead to thrombophlebitis, subdural abscess, meningetis, etc.
        
        Can create thrombosis of cerebral arteries and affect eight cranial nerve along with surrounding cranial nerves in the presence of basilar meningitis
- - - - Video nystagmography/electronystagmography
      - Bithermal Caloric Test (COWS - cold opposite, warm same)
      - Rotational chair testing
      - Electrocochleography
      - Subjective visual vertical or horizontal
      - Vestibular evoked Myogenic potentials
      - Gaze stability, posturography (ie. sensory organization test) Dynamic visual acuity