Case Scenario: Vestibular Disorders

Case Scenario: In the history provided by a patient whose chief complaint is of dizziness and imbalance, the patient reports having gone to the Emergency Department 3 months ago due to a sudden onset of severe vertigo that lasted 1 to 2 days, and was followed by a gradual easing of symptoms over a period of several days.

This pattern of symptoms suggests the possibility of:

BPPV Ménière’s Disease Lateral Medullary infarct

Vestibular neuritis

The sudden onset of severe vertigo and spontaneous nystagmus (observed by the MD in the Emergency Department) in this patient was likely the result of:

Otoconia in the semi-circular canal An alteration in the tonic firing rate of the vestibular nuclei

Otoconia attached to the cupula An alteration in the firing rate of the hair cells due to a structural abnormality

Which 2 performance-based measures at the body function and structure level of the ICF are valid for use with individuals with vestibular disorders?

Dizziness Handicap Inventory and Dynamic Gait Index Gait velocity and Dynamic Gait Index CTSIBm and Sharpened Rhomberg CTSIBm and Five Times Sit-to-Stand test

Recovery of gaze stability in individuals with unilateral incomplete loss of vestibular function is believed to occur due to:

Increasing the gain of the vestibulo-ocular reflex and re-growth of damaged hair cells Increasing the gain of the vestibulo-ocular reflex and substitution of alternative strategies

Substitution of alternative strategies Habituation and re-innervation of the vestibular nerve

Resolution of spontaneous nystagmus within 24 hours after unilateral vestibular damage occurs as a result of:

Spontaneous recovery at the level of the vestibular nuclei

Cessation of head movement Performing gaze stability exercises Otoconia being removed from the semi-circular canal

Case Scenario: You are treating a patient in a rehabilitation