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Sensorintegrative dysfunction underlying vestibular disorders after traumatic brain injury: A review. Laura M. Franke, PhD; William C. Walker, MD; David X. Cifu, MD; Alfred L. Ochs, PhD; Henry L. Lew, MD, PhD. Aim Current methods of assessing vestibular system:
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Sensorintegrative dysfunction underlying vestibular disorders after traumatic brain injury: A review Laura M. Franke, PhD; William C. Walker, MD; David X. Cifu, MD; Alfred L. Ochs, PhD; Henry L. Lew, MD, PhD
Aim • Current methods of assessing vestibular system: • Describe vestibular deficits after traumatic brain injury. • Differentiate blunt and blast trauma. • Have not examined full range of vestibular functions that depend on cerebral structures above midbrain. • Relevance • Vestibular symptoms are persistent and problematic sequelae of blast exposure. • Evidence suggests that these symptoms often stem from injury to central nervous system (CNS).
Methods • Reviewed English-language articles with human participants on PubMed and Google Scholar using following search terms: • mild traumatic brain injury, blast injury, vestibular, balance, dizziness, vestibule-ocular reflex, posturography, subjective visual vertical, central nervous system, cortex, vestibular cortex, lesions, neuroimaging
Results • Damage to central vestibular circuits can lead to deficits in vital processes of spatial perception and navigation, dizziness, and disequilibrium. • May also affect emotional functioning, particularly noradrenergically modulated states of anxiety. • Perceptual functions can be assessed to determine CNS involvement in vestibular symptoms and provide greater confidence when excluding vestibular dysfunction.
Conclusion • Ability to detect central vestibular dysfunction will significantly enhance our response to dizziness and balance symptoms that are common source of distress for veterans.