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Evaluation of vestibular function

Evaluation of vestibular function. Chunfu Dai M.D & Ph.D. Balance is a highly integrated network. vestibular system -rotatory stimulation and linear acceleration Information proprioceptive system - information input from the feet, ankle, hip, and neck

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Evaluation of vestibular function

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  1. Evaluation of vestibular function Chunfu Dai M.D & Ph.D

  2. Balance is a highly integrated network • vestibular system -rotatory stimulation and linear acceleration Information • proprioceptive system - information input from the feet, ankle, hip, and neck • ocular system - visual perception of spatial orientation is supplied by the • central nervous system - integrated these information and translated to fine motor movements

  3. Static balance test • Romberg test: useful in patients with an acute unilateral labyrinthine lesion • Mann test: the patient stands heel to toe rather than with feet together • Static posturography:

  4. Dynamic balance test • Dynamic posturography • Co-ordination function test: • Point nose test • Alternative movement • Finger point

  5. Nystagmus • Nystagmus • Slow phase: hypoactivity • Quick phase: hyperactivity • Direction: quick movement of eye • Plane: horizontal, rotary, vertical • Degree: • I: quick phase side • II: quick phase side and look forward • III: quick phase side, slow phase side and look forward

  6. Ocular dysmetria test: • Brainstem, or cerebellum lesion • Smooth purpsuit test: • Brainstem or cerebellum lesion • Optokinetic nystagmus • Lesion in central never system • Gaze nystagmus • Lesion in central nerve system

  7. Caloric test: • Horizontal semicircular canal • Temperature: 44 and 30 • Stimuli duration: 40s • Rotation test

  8. Fistula sign • Fistula was blocked by granuloma or cholesteatom • Dead labyrinth • Hennebert sign • Tullio phenomeno

  9. (1) gaze (fixation) test,(2) ocular pursuit test,(3) optokinetic test,(4) static positional test,(5) dynamic positioning test, and(6) bithermal caloric test.

  10. The normal response as the chair is rotated is slow compensatory eye movement in the direction opposite the rotation with a fast saccade to return the eye in the forward position. • The test has three parameters--phase (time for the slow phase eye movement in relationship to the head rotation velocity), gain (ratio of maximum eye velocity to maximum chair velocity), and symmetry (compares the slow-phase eye velocity when rotating right versus left).52

  11. the test addresses two major areas: • (1) motor control test which examines the patient's motor system and the ability of the CANS to adapt to changing conditions, and(2) sensory organization test which examines proprioceptive, visual, and vestibular systems working as an integrated whole.

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