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Vestibular Rehabilitation 1 - Coggle Diagram
Vestibular Rehabilitation 1
Anatomy
Peripheral
Vestibular system
Otolith
Semi-circular canals
Central
Cerebellum
Brainstem
Occulomotor
How do we
assess dizziness?
Subjective
Onset of dizziness
Duration and intensity
Aggravating factors / movements
Time to settle
Hearing / vision changes
Neurological signs
Objective
HINTS (if in 24 hr period)
Smooth pursuit
Saccades
Nystagmus (resting)
Skew deviation
Head thrust
VOR cancellation
Neurological coordination/strength/sensation
Dix Hall-Pike
Red Flags
5 D's
Direction changing nystagmus
Neurological signs
Sudden hearing loss
Causes of
Dizziness
Peripheral
Unilateral Hypofunction
BPPV
sudden onset dizziness
population > 45yrs
short duration of dizziness
aggravated with head movement
settles when movement stopped
Vestibular Neuritis
Rapid onset dizziness
Dizziness doesn't settle, constant
may have auditory symptoms
Central
Stroke
constant dizziness
unbalanced standing/walking
other neurological signs
+/- headaches
Tumour
What is the Treatment for
Dizziness
Stroke
Referral to MD
Stroke pathway
MDT involvement
Balance/gait/coordination retraining
BPPV
Epley Manouvere
Advice and education
Vestibular gaze stabilisation ex's
Unilateral Hypofunction
Advice and education
Vestibular rehab (longer term)
Gait/balance retraining
How do we differentially diagnose between vestibular conditions?