A Flow Chart For Classification Of Nystagmus
|
|
|
- Susan Cole
- 7 years ago
- Views:
Transcription
1 A Flow Chart For Classification Of Nystagmus Is fixation impaired because of a slow drift, or an intrusive saccade, away from the target? If a slow drift is culprit Jerk Pendular Unidrectional (constant velocity) Central Peripheral (Use effect of fixation and vector of nystagmus) Changes direction with viewing eye = Latent Nystagmus Changes direction with direction of gaze (gaze-evoked) Acquired (velocity decreasing e.g. cerebellar) Acquired (MS or OPT) or Congenital Congenital (velocity increasing)
2 A Flow Chart For Classification Of Nystagmus If a saccade away from the fixation target (saccadic intrusion) is the culprit? With an intersaccadic interval (~200 ms) before a return saccade Without an intersaccadic interval (back to back saccades) Square-wave jerks (small saccades away from and back to fixation), macrosquare wave jerks (much larger saccades) Macrosaccadic oscillations, Large saccades around fixation (extreme degree of saccade hypermetria) Opsoclonus (multiaxis) Ocular Bobbing Single vertical saccade away from fixation followed by slow drift back Flutter (one axis) Includes voluntary nystagmus
3 Waveforms of Nystagmus Jerk or linear (vestibular) Velocity decreasing (acquired gaze-evoked, congenital latent) Velocity increasing (congenital) Pendular
4 SCC Organization: a guide to nystagmus Arrows indicate direction of slow phase with stimulation Central Patterns Peripheral Pattern Flourens
5 Summary table of nystagmus treatment (Strupp et al, J Neurology, 2011) Downbeat nystagmus (DBN) Upbeat nystagmus (UBN) Acquired pendular nystagmus (APN) Period alternating nystagmus (PAN) Infantile (congenital) nystagmus Direction of nystagmus (quick phase) downward, may be diagonal with lateral gaze upward mainly horizontal, may have vertical and/or torsional components horizontal mainly horizontal; may have torsional and small vertical components Waveform (slow phase) Special features jerk, constant, increasing, or decreasing slowphase velocity increased intensity during lateral and downward gaze; sometimes suppressed by convergence jerk, constant, increasing, or decreasing slowphase velocity increased intensity during upward gaze; may convert to DBN on convergence pendular, sinusoidal slowphase associated with other oscillations (e.g., palate) and with hypertrophic degeneration of the inferior olive Jerk, mostly constant slowphase velocity changes direction every 90 to 120 sec accelerating slowphases; foveation periods when the eye is transiently still null zone, in which nystagmus is minimal; often suppressed with convergence Sites of lesion cerebellum (bilateral floccular hypofunction); rarely lower brainstem lesions medial medulla, pontomesencephalic junction, rarely cerebellum pontomedullary, probably affecting components of neural integrator for gaze holding cerebellum (nodulus, uvula) uncertain; some cases are associated with afferent visual system anomalies Etiology cerebellar tumors, degenerations, and stroke; idiopathic; often associated with bilateral vestibulopathy and neuropathy brainstem or cerebellar stroke and tumors; Wernicke s encephalopathy multiple sclerosis, oculopalatal tremor due to brainstem or cerebellar stroke cerebellar degenerations, cranio-cervical anomalies, multiple sclerosis, cerebellar tumors and stroke uncertain; may be associated with afferent visual system anomalies; hereditary in some patients (e.g., FRMD7 mutations) Treatment 4-aminopyridine (5-10 mg tid), 3,4- diaminopyridine (10-20 mg tid), baclofen (5 mg tid) clonazepam (0.5 mg tid) often transient, treatment often not necessary; baclofen (5-10 mg tid) 4-aminopyridine (5-10 tid) memantine (10 mg qid) gabapentin (300 mg qid) baclofen (5-10 mg tid) gabapentin (300 mg qid) memantine (10 mg qid)
6 A Phone Call from an Acutely Vertiginous Patient: Key Diagnoses Stroke BPPV Neuritis Migraine Menieres Headache, Neck pain, Other Neurological Symptoms (diplopia, numbness, weakness, hiccoughs, dysphagia, dysarthria, incoordination), Hearing loss, Risk Factors (age, hypertension, lipid disorder, heart disease, diabetes) Positional, Usually turning over or getting in and out of bed, Transient, Recent inciting events (dentist, hair dresser, trauma, bed rest), Happened before? Sustained vertigo even when at rest though worsened by movement, No hearing change, Viral illness Neurological symptoms? Headache or neck pain? Any previous episodes? Duration of the spell? Is it positional? Hearing symptoms? Age? Vascular risk factors? Headache, Family or personal history of migraine, Headaches may only be remote, Triggers, aura Light and noise sensitivity, Relieved by sleep Aural symptoms (pain, pressure, fullness in ear, seashell tinnitus, Fluctuating hearing loss (low frequency) Otolithic crises of Tumarkin Reversals of direction of vertigo, Lermoyez (hearing improves as vertigo begins)
7 Stroke The Acutely Vertiginous Patient: Key Findings BPPV Neuritis Migraine Menieres Spontaneous jerk nystagmus that does not suppress with fixation, Gaze-evoked, direction - changing nystagmus, Skew deviation, Absent head impulse sign (though if present does not r/o stroke) Other neurological signs including hearing loss Positioning nystagmus, Transient, after a latency, usually mixed vertical torsional if posterior canal or horizontal if lateral canal. Posterior canal BPPV changes direction on sitting up, Lateral canal may be apogeotropic (beats to sky) or geotropic (beats to ground) When most intense is beating toward involved ear Spontaneous, sustained, mixed horizontaltorsional nystagmus in straight ahead gaze. Obeys Alexander s law (more intense with gaze in the direction of quick phase) More intense when lying with bad ear down. Suppressed with fixation, Positive head impulse sign May mimic BPPV or Neuritis or have central ocular motor signs (gazeevoked or vertical nystagmus) Spontaneous nystagmus similar to vestibular neuritis, Nystagmus may spontaneously change direction in the first minutes and then hours after onset. Loss of hearing, especially low frequency, Henneberts sign (tragal compression produces nystagmus)
8 Epley Semont Helminski, Zee et al.
Less common vestibular disorders presenting with funny turns
Less common vestibular disorders presenting with funny turns Charlotte Agrup, Department of Neuro-otology, The National Hospital for Neurology and Neurosurgery, London Making the diagnosis Making the diagnosis
A Flow Chart For Classification Of Nystagmus
A Flow Chart For Classification Of Nystagmus Is fixation impaired because of a slow drift, or an intrusive saccade, away from the target? If a slow drift is the culprit Jerk Pendular Unidirectional Vestibular
Workup and Management of Vertigo
Workup and Management of Vertigo S. Andrew Josephson, MD Department of Neurology University of California San Francisco October 25, 2008 The speaker has no disclosures Two Key Questions 1. What do you
Proposed Treatment for Vestibular Dysfunction in Dogs By Margaret Kraeling, DPT, CCRT
Proposed Treatment for Vestibular Dysfunction in Dogs By Margaret Kraeling, DPT, CCRT Vestibular dysfunction in the dog can be a disturbing condition for owners, as well as somewhat confounding for the
GAZE STABILIZATION SYSTEMS Vestibular Ocular Reflex (VOR) Purpose of VOR Chief function is to stabilize gaze during locomotion. Acuity declines if
GAZE STABILIZATION SYSTEMS Vestibular Ocular Reflex (VOR) Purpose of VOR Chief function is to stabilize gaze during locomotion. Acuity declines if slip exceeds 3-5 deg/sec. Ex: Head bobbing and heel strike
Benign Paroxysmal Positional Vertigo. By Mick Benson
Benign Paroxysmal Positional Vertigo By Mick Benson Definition Benign - not life-threatening Paroxysmal - a sudden onset Positional - response provoked by change in head position Vertigo - sensation of
Understanding Nystagmus: Diagnosis, Related Disorders, Treatment, and Research
Understanding Nystagmus: Diagnosis, Related Disorders, Treatment, and Research Mitra Maybodi,, MD Children s National Medical Center George Washington University School of Medicine and Health Sciences
CONGENITAL NYSTAGMUS WHEN TO RECORD HOW TO TREAT 2009
CONGENITAL NYSTAGMUS WHEN TO RECORD HOW TO TREAT 2009 LIONEL KOWAL Royal Victorian Eye and Ear Hospital Center for Eye Research Australia Melbourne, Australia TYPES OF CONGENITAL NYSTAGMUS cn cn: any type
II. VESTIBULAR SYSTEM OVERVIEW
HM513 Vertigo and Dizziness; Vestibular System Disorders - Summary Eric Eggenberger*, DO and Kathryn Lovell, PhD *Co-Director, MSU Neuro-Visual Unit; *Director, MSU Ocular Motility Lab Department of Neurology
Vestibular Assessment
Oculomotor Examination A. Tests performed in room light Vestibular Assessment 1. Spontaneous nystagmus 2. Gaze holding nystagmus 3. Skew deviation 4. Vergence 5. Decreased vestibular ocular reflex i. Head
DIAGNOSTIC CRITERIA OF STROKE
DIAGNOSTIC CRITERIA OF STROKE Diagnostic criteria are used to validate clinical diagnoses. Here below MONICA diagnostic criteria are reported. MONICA - MONItoring trends and determinants of CArdiovascular
SPECIALITY: AUDIOVESTIBULAR MEDICINE CLINICAL PROBLEMS: DIZZINESS, VERTIGO AND IMBALANCE. Introduction
St Richard s Hospital SPECIALITY: AUDIOVESTIBULAR MEDICINE CLINICAL PROBLEMS: DIZZINESS, VERTIGO AND IMBALANCE Introduction Whilst dizziness, vertigo and imbalance may be due to systemic disease, they
Concussion/MTBI Certification Series. Featuring: Frederick R Carrick, DC, PhD Distinguished Professor of Neurology, Life University
Concussion/MTBI Certification Series Featuring: Frederick R Carrick, DC, PhD Distinguished Professor of Neurology, Life University Please note that spaces are limited for this specialty certification program.
Dizziness and Vertigo
Dizziness and Vertigo Introduction When you are dizzy, you may feel lightheaded or lose your balance. If you also feel that the room is spinning, you may have vertigo. Vertigo is a type of severe dizziness.
Definition of Positional Vertigo. Positional Vertigo. Head r.e. Gravity. Frames of reference. Case SH. Dix Hallpike was positive
Positional Vertigo Definition of Positional Vertigo Timothy C. Hain, MD Departments of Neurology, Otolaryngology and Physical Therapy Northwestern University, Chicago, IL Sensation of motion Elicited by
Otologic (Ear) Dizziness. Fistula Other. SCD Bilateral. Neuritis. Positional Vertigo BPPV. Menieres
Otologic Dizziness (Dizziness from Ear) Ear Structures of importance Timothy C. Hain, MD Northwestern University, Chicago t-hain@northwestern.edu The ear is an inertial navigation device Semicircular Canals
Eye Muscle Surgery for Acquired Forms of Nystagmus
13 Eye Muscle Surgery for Acquired Forms of Nystagmus ROBERT L. TOMSAK, LOUIS F. DELL'OSSO, JONATHAN B. JACOBS, ZHONG I. WANG, AND R. JOHN LEIGH ABSTRACT We report 3 patients with acquired nystagmus who
Objectives. Early Detection of Vestibular Dysfunction. Early Detection of Vestibular Disorders in Individuals with Brain Injury
Early Detection of Vestibular Disorders in Individuals with Brain Injury Jordana Gracenin PT, DPT Sara Schwartz PT, DPT, NCS Objectives 1. The learner will be able to identify anatomy and physiology of
Fourth Nerve Palsy (a.k.a. Superior Oblique Palsy)
Hypertropia Hypertropia is a type of strabismus characterized by vertical misalignment of the eyes. Among the many causes of vertical strabismus, one of the most common is a fourth nerve palsy (also known
ICD-9 to ICD-10 Conversion Commonly Used Neurologic Diagnosis
ICD-9 to ICD-10 Conversion Commonly Used Neurologic Diagnosis 327.20 Organic sleep apnea, unspecified... 1 331.0 Alzheimer s disease...3 333.1 Essential and other specified forms of tremor...4 340 Multiple
DIZZINESS, VERTIGO, AND HEARING LOSS
C H A P T E R 18 DIZZINESS, VERTIGO, AND HEARING LOSS Kevin A. Kerber and Robert W. Baloh General Considerations 237 Historical Background 237 Epidemiology of Vertigo, Dizziness, and Hearing Loss Normal
1. Introduction 1.1 Definition and epidemiology of vertigo
1. Introduction Vertigo is one of the most common complaints in neurology and otology. Its prevalence increases with age but is often underestimated in elderly adults (1). Although most cases of vertigo
Chiari malformations
A fact sheet for patients and carers Chiari malformations This fact sheet provides information on Chiari malformations. It focuses on Chiari malformations in adults. Our fact sheets are designed as general
Vestibular Rehabilitation What s the Spin?
Vestibular Rehabilitation What s the Spin? Carolyn Tassini, PT, DPT, NCS Vestibular Certified Rehabilitation Supervisor Bancroft NeuroRehab Objectives Attendees demonstrate a basic understanding of the
How To Diagnose Stroke In Acute Vestibular Syndrome
Danica Dummer, PT, DPT, University of Utah Abigail Reid, PT, DPT, Kessler Institute for Rehabilitation Online Journal Club-Article Review Article Citation Study Objective/Purpose (hypothesis) Study Design
Benign Paroxysmal Nystagmus (BPN)
Benign Paroxysmal Nystagmus (BPN) AKA: Benign Paroxysmal Positional Nystagmus (BPPN) Benign Paroxysmal Positional Vertigo (BPPV) Benign Positional Vertigo (BPV) Brief attacks of rotatory vertigo +/- nausea
Dizziness: More than BPPV or Meniere s. William J Garvis, MD Otology, Neurotology & Skull Base Surgery Ear, Nose & Throat SpecialtyCare of MN, PA
Dizziness: More than BPPV or Meniere s William J Garvis, MD Otology, Neurotology & Skull Base Surgery Ear, Nose & Throat SpecialtyCare of MN, PA American Family Physician Dizziness: A Diagnostic Approach
Introduction to Dizziness and the Vestibular System
Introduction to Dizziness and the Vestibular System David R Friedland, MD, PhD Professor and Vice-Chairman Chief, Division of Otology and Neuro-otologic Skull Base Surgery Chief, Division of Research Department
Vestibular Rehabilitation Therapy. Melissa Nelson
Vestibular Rehabilitation Therapy Melissa Nelson What is Vestibular Rehabilitation Therapy (VRT)? VRT is an exercise-based program designed to promote CNS compensation for inner ear deficits. The goal
Paediatric Bell s Palsy Paediatric Update November 2014
Paediatric Bell s Palsy Paediatric Update November 2014 Richard Webster, Paediatric Neurologist Children s Hospital at Westmead Typical history Unilateral LMN facial weakness Acute onset over a day or
Speaker: Shayla Moore, BMR(PT) Relationship with commercial interests: Employee at Creekside Physiotherapy Clinic
Speaker: Shayla Moore, BMR(PT) Relationship with commercial interests: Employee at Creekside Physiotherapy Clinic 1 Vestibular Rehabilitation Managing dizziness to maintain mobility in the elderly" Dizziness:
Directions for construction used with permission from Pacific Science Center - Brain Power
Directions for construction used with permission from Pacific Science Center - Brain Power The Vestibular System The vestibular system within the inner ear detects both the position and motion of the head
Recommended management of vestibular causes of dizziness
Recommended management of vestibular causes of dizziness SPL Peter Rea MA, FRCS Most patients with vestibular causes of dizziness can now be treated with either drug therapy or vestibular physiotherapy.
22/02/2015. Possible causes. Decisions decisions decisions. Challenging eye and ear conditions at underwriting and claim stage Dr Maritha van der Walt
Challenges Underwriting symptoms rather than conditions- tinnitus, vertigo, blurred vision Requests for narrower rather than broad exclusions and consequences Pre existing condition and unrelated claims
National Hospital for Neurology and Neurosurgery. Migraine associated dizziness Department of Neuro-otology
National Hospital for Neurology and Neurosurgery Migraine associated dizziness Department of Neuro-otology If you would like this document in another language or format or if you require the services of
Vertebrobasilar Disease
The Vascular Surgery team at the University of Michigan is dedicated to providing exceptional treatments for in the U-M Cardiovascular Center (CVC), our new state-of-the-art clinical facility. Treatment
Dizziness and Vertigo: Emergencies and Management
Dizziness and Vertigo: Emergencies and Management Ronald J. Tusa, MD, PhD a, *, Russell Gore, MD b KEYWORDS Vertigo Dizziness Vestibular Imbalance Emergency room Nystagmus A 49-year-old woman is brought
How to test ocular movements in PSP Jan Kassubek
How to test ocular movements in PSP Jan Kassubek Universitätsklinik für Neurologie, Ulm Bedside Screening: PSP initially slowing of vertical saccades slowing of downward saccades is considered the hallmark
Group Benefits Evidence of Insurability for Comprehensive Optional Critical Illness Insurance
Group Benefits Evidence of Insurability for Comprehensive Optional Critical Illness Insurance INSTRUCTIONS - Please print all answers If required, retain a photocopy for your files. 1a) Plan contract number(s)
Vertigo: A Review of Common Peripheral and Central Vestibular Disorders
The Ochsner Journal 9:20 26, 2009 f Academic Division of Ochsner Clinic Foundation Vertigo: A Review of Common Peripheral and Central Vestibular Disorders Timothy L. Thompson, MD, Ronald Amedee, MD Department
Benign Paroxysmal Positional Vertigo (BPPV)
Benign Paroxysmal Positional Vertigo (BPPV) UHN Information for Patients Patient Education Improving Health Through Education You have been told by your doctor that you have Benign Paroxysmal Positional
Dizziness and balance problems
Dizziness and balance problems Dizziness and balance problems, Action on Hearing Loss Information, May 2011 1 Dizziness and balance problems This factsheet is part of our Ears and ear problems range. It
Dallas Neurosurgical and Spine Associates, P.A Patient Health History
Dallas Neurosurgical and Spine Associates, P.A Patient Health History DOB: Date: Reason for your visit (Chief complaint): Past Medical History Please check corresponding box if you have ever had any of
Benign Paroxysmal Positional Vertigo David Solomon, MD, PhD
Benign Paroxysmal Positional Vertigo David Solomon, MD, PhD Address Department of Neurology, University of Pennsylvania, 3 W. Gates Building, 3400 Spruce Street, Philadelphia, PA 19104-4283, USA. Email:
X-Plain Trigeminal Neuralgia Reference Summary
X-Plain Trigeminal Neuralgia Reference Summary Introduction Trigeminal neuralgia is a condition that affects about 40,000 patients in the US every year. Its treatment mostly involves the usage of oral
VESTIBULAR REHAB ON THE REZ
VESTIBULAR REHAB ON THE REZ Lessons Learned in 4 Years of Starting Vestibular Rehab Services in Central Navajo Area LT Selena Bobula, DPT, NCS Senior Physical Therapist Coordinator, Navajo Area Neuro Special
Headaches in Children
Children s s Hospital Headaches in Children Manikum Moodley, MD, FRCP Section of Pediatric Neurology The Cleveland Clinic Foundation Introduction Headaches are common in children Most headaches are benign
Optic Neuritis. The optic nerve fibers are coated with myelin to help them conduct the electrical signals back to your brain.
Optic Neuritis Your doctor thinks that you have had an episode of optic neuritis. This is the most common cause of sudden visual loss in a young patient. It is often associated with discomfort in or around
Cerebellum and Basal Ganglia
Cerebellum and Basal Ganglia 1 Contents Cerebellum and Basal Ganglia... 1 Introduction... 3 A brief review of cerebellar anatomy... 4 Basic Circuit... 4 Parallel and climbing fiber input has a very different
Esotropia (Crossed Eye(s))
Esotropia (Crossed Eye(s)) Esotropia is a type of strabismus or eye misalignment in which the eyes are "crossed," that is, while one eye looks straight ahead, the other eye is turned in toward the nose.
Balance and Vestibular Center Programs to treat dizziness and reduce your risk of falling
Balance and Vestibular Center Programs to treat dizziness and reduce your risk of falling Helping you overcome dizziness and vertigo Most people will experience dizziness at some point in their lives.
Pathoanatomical Changes of the Brachial Plexus and of C5-C6 Following Whiplash-Type Injury: A Case Report
Pathoanatomical Changes of the Brachial Plexus and of C5-C6 Following Whiplash-Type Injury: A Case Report 1 Journal Of Whiplash & Related Disorders Vol. 1, No, 1, 2002 Gunilla Bring, Halldor Jonsson Jr.,
Primary Motor Pathway
Understanding Eye Movements Abdullah Moh. El-Menaisy, MD, FRCS Chief, Neuro-ophthalmology ophthalmology & Investigation Units, Dhahran Eye Specialist Hospital, Dhahran, Saudi Arabia Primary Motor Pathway
CHPN Review Course Pain Management Part 1 Hospice and Palliative Nurses Association
CHPN Review Course Pain Management Part 1 Disclosures Bonnie Morgan has no real or perceived conflicts of interest that relate to this presentation. Copyright 2015 by the. HPNA has the exclusive rights
ICD-9-CM coding for patients with Traumatic Brain Injury*
ICD-9-CM coding for patients with Traumatic Brain Injury* The diagnostic code for sequelae of traumatic brain injury is: 907.0 Late effect of intracranial injury without mention of skull fracture (Late
Chiari Malformation: Symptoms
Chiari Malformation: Symptoms SYMPTOMS DIAGNOSIS LIVING WITH CHIARI TREATMENT Rick Labuda, Executive Director director@conquerchiari.org 724-940-0116 Disclaimer: This presentation is intended for informational
Interval: [ ] Baseline [ ] 2 hours post treatment [ ] 24 hours post onset of symptoms ±20 minutes [ ] 7-10 days [ ] 3 months [ ] Other ( )
![Interval: [ ] Baseline [ ] 2 hours post treatment [ ] 24 hours post onset of symptoms ±20 minutes [ ] 7-10 days [ ] 3 months [ ] Other ( )](/thumbs/29/13263233.jpg "Interval: [ ] Baseline [ ] 2 hours post treatment [ ] 24 hours post onset of symptoms ±20 minutes [ ] 7-10 days [ ] 3 months [ ] Other ( )")
Patient Identification. - - Pt. Date of Birth / / Hospital ( - ) Date of Exam / / Interval: [ ] Baseline [ ] 2 hours post treatment [ ] 24 hours post onset of symptoms ±20 minutes [ ] 7-10 days [ ] 3 months
Vision Health: Conditions, Disorders & Treatments NEUROOPTHALMOLOGY
Vision Health: Conditions, Disorders & Treatments NEUROOPTHALMOLOGY Neuroophthalmology focuses on conditions caused by brain or systemic abnormalities that result in visual disturbances, among other symptoms.
Benign Paroxysmal Positioning Vertigo and Sleep: A Polysomnographic Study of Three Patients
Sleep Research Online 5(2): 53-58, 2003 http://www.sro.org/2003/monstad/53/ Printed in the USA. All rights reserved. 1096-214X 2003 WebSciences Benign Paroxysmal Positioning Vertigo and Sleep: A Polysomnographic
Lecture Plan. Anatomy and Pathophysiology of the Vestibular System. Vestibular Overview. Vestibular Physiology. Vestibulo-ocular reflex V.O.R.
Anatomy and Pathophysiology of the Vestibular System Lecture Plan 1. Vestibular Physiology 2. Anatomy and clinical syndromes Timothy C. Hain, MD Vestibular Physiology Vestibular Overview Vestibular sensors
Headaches in Children How to Manage Difficult Headaches
Headaches in Children How to Manage Difficult Headaches Peter Procopis Childhood headaches Differential diagnosis Migraine Psychological Raised Pressure Childhood headaches Other causes: Constitutional
Instructional Course Handout: Surgery For Nystagmus:
Instructional Course Handout: Surgery For Nystagmus: Richard W. Hertle, M.D., F.A.A.O., F.A.C.S., F.A.A.P. Chief of Pediatric Ophthalmology Director of The Laboratory of Visual and Ocular Motor Physiology
Dizziness is the third most common ma -
CMAJ Review Does my dizzy patient have a stroke? A systematic review of bedside diagnosis in acute vestibular syndrome Alexander A. Tarnutzer MD, Aaron L. Berkowitz MD PhD, Karen A. Robinson PhD, Yu-Hsiang
Nystagmus and oscillopsia
CHAPTER 32 Nystagmus and oscillopsia A. Straube, 1 A. Bronstein, 2 D. Straumann3 1 University of Munich, Germany; 2 Imperial College of Science, Technology and Medicine, London, UK; 3 University of Zurich,
Trouble Getting a Diagnosis?
PO BOX 13305 PORTLAND, OR 97213 FAX: (503) 229-8064 (800) 837-8428 INFO@VESTIBULAR.ORG WWW.VESTIBULAR.ORG By the Vestibular Disorders Association Trouble Getting a Diagnosis? Many people who suffer from
BALANCE AND VESTIBULAR REHABILITATION THERAPY MANUAL
BALANCE AND VESTIBULAR REHABILITATION THERAPY MANUAL Copyright AMERICAN HEARING & BALANCE CENTERS, INC., 2010 2010 Revision 3.01 TABLE OF CONTENTS Description Page Five Indications For Therapy... 1 Treatments
EMG and the Electrodiagnostic Consultation for the Family Physician
EMG and the Electrodiagnostic Consultation for the Family Physician Stephanie Kopey, D.O., P.T. 9/27/15 The American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM) Marketing Committee
Hearing anatomy and types of hearing loss. How to detect hearing loss in your patients How to interpret audiograms
Outline for today Hearing system refresher Hearing anatomy and types of hearing loss Hearing loss in General Practice How to detect hearing loss in your patients How to interpret audiograms When to refer
Common visual symptoms and findings in MS: Clues and Identification
Common visual symptoms and findings in MS: Clues and Identification Teresa C Frohman, PA-C, MSCS Neuro-ophthalmology Research Manager, UT Southwestern Medical Center at Dallas Professor Biomedical Engineering,
Paraneoplastic Antibodies in Clinical Practice. Mohammed El lahawi New Cross Hospital Wolverhampton
Paraneoplastic Antibodies in Clinical Practice Mohammed El lahawi New Cross Hospital Wolverhampton 1 Effects of Neoplasm Direct mass ( pressure ) effect Metastasis effect Remote effect 2 The Nervous System
Internuclear ophthalmoplegia: recovery and plasticity
Internuclear ophthalmoplegia: recovery and plasticity M. J. Doslak, L. B. Kline, L. F. Dell'Osso, and R. B. Daroff We studied refixational eye movements of a patient during the gradual resolution of an
Differential Diagnosis of Craniofacial Pain
1. Differential Diagnosis of Craniofacial Pain 2. Headache Page - 1 3. International Headache Society International Classification... 4. The Primary Headaches (1-4) Page - 2 5. The Secondary Headaches
The Physiology of the Senses Lecture 11 - Eye Movements www.tutis.ca/senses/
The Physiology of the Senses Lecture 11 - Eye Movements www.tutis.ca/senses/ Contents Objectives... 2 Introduction... 2 The 5 Types of Eye Movements... 2 The eyes are rotated by 6 extraocular muscles....
Vision and Rehabilitation After Brain Trauma Eric Singman, MD, PhD, Health.mil
Vision and Rehabilitation After Brain Trauma Eric Singman, MD, PhD, Health.mil This article was first accessed at Brainline.org. Vision Problems After Brain Injury Visual problems following brain trauma
SOUTH TAMPA MULTIPLE SCLEROSIS CENTER
SOUTH TAMPA MULTIPLE SCLEROSIS CENTER PATIENT/CARE GIVER QUESTIONNAIRE DEMOGRAPHIC INFORMATION Patient's Name: City: State: Zip Code: Phone: Marital Status: Spouse/Care Giver Name: Phone (H) (W) Occupation:
Baseline Shift and Gain Asymmetry in the Caloric Test
i n p r a c t i c e F O R C L I N I C A L A U D I O L O G Y March 2010 Baseline Shift and Gain Asymmetry in the Caloric Test Kamran Barin, Ph.D. Biography: Kamran Barin, Ph.D., is Director of Balance Disorders
IF IN DOUBT, SIT THEM OUT.
IF IN DOUBT, SIT THEM OUT. Scottish Sports Concussion Guidance: Grassroots sport and general public Modified from World Rugby s Guidelines on Concussion Management for the General Public Introduction The
3nd Biennial Contemporary Clinical Neurophysiological Symposium October 12, 2013 Fundamentals of NCS and NMJ Testing
3nd Biennial Contemporary Clinical Neurophysiological Symposium October 12, 2013 Fundamentals of NCS and NMJ Testing Peter D. Donofrio, M.D. Professor of Neurology Vanderbilt University Medical Center
AMERICAN ACADEMY OF NEUROLOGY NEURO-OPHTHALMOLOGY/NEURO-OTOLOGY FELLOWSHIP CORE CURRICULUM
AMERICAN ACADEMY OF NEUROLOGY NEURO-OPHTHALMOLOGY/NEURO-OTOLOGY FELLOWSHIP CORE CURRICULUM A CURRICULUM FOR NEURO-OPHTHALMOLOGY Definition and Scope Neuro-ophthalmology focuses on brain and systemic abnormalities
Clinical features. Chapter 2. Clinical manifestations. Course
Chapter 2 Clinical features Clinical manifestations The wide range of symptoms and signs of multiple sclerosis (MS) reflect multifocal lesions in the central nervous system (CNS), including in the afferent
Handicap after acute whiplash injury A 1-year prospective study of risk factors
1 Handicap after acute whiplash injury A 1-year prospective study of risk factors Neurology 2001;56:1637-1643 (June 26, 2001) Helge Kasch, MD, PhD; Flemming W Bach, MD, PhD; Troels S Jensen, MD, PhD From
Anterior semicircular canal benign paroxysmal positional vertigo and positional downbeating nystagmus
American Journal of Otolaryngology Head and Neck Medicine and Surgery 27 (2006) 173 178 www.elsevier.com/locate/amjoto Anterior semicircular canal benign paroxysmal positional vertigo and positional downbeating
Guideline for the Management of Acute Peripheral Facial nerve palsy. Bells Palsy in Children
Guideline for the Management of Acute Peripheral Facial nerve palsy Definition Bells Palsy in Children Bell palsy is an acute, idiopathic unilateral lower motor neurone facial nerve palsy that is not associated
CLINICAL NEUROPHYSIOLOGY
CLINICAL NEUROPHYSIOLOGY Barry S. Oken, MD, Carter D. Wray MD Objectives: 1. Know the role of EMG/NCS in evaluating nerve and muscle function 2. Recognize common EEG findings and their significance 3.
Symptoms can come and go; some are much more responsive to treatment whereas others are more difficult to manage.
Choices Symptoms MS-UK believes that based on experience, people cope best when they look at what is happening, rather than what might be. MS can cause a long list of symptoms. This list is not exhaustive
NEUROLOCALIZATION MADE EASY
NEUROLOCALIZATION MADE EASY Jared B. Galle, DVM, Diplomate ACVIM (Neurology) Dogwood Veterinary Referral Center 4920 Ann Arbor-Saline Road Ann Arbor, MI 48103 Localizing a neurologic problem to an anatomical
A Definition of Multiple Sclerosis
English 182 READING PRACTICE by Alyx Meltzer, Spring 2009 Vocabulary Preview (see bolded, underlined words) gait: (n) a particular way of walking transient: (adj) temporary; synonym = transitory remission:
Coping with Symptoms of Multiple Sclerosis
Coping with Symptoms of Multiple Sclerosis Josée Poirier B. Sc. Nursing, MSCN Outline What Is a Pseudo exacerbation? Awareness Advancement of Treatments Treatment of Symptoms Uhthoff s Phenomenon What
F r e q u e n t l y A s k e d Q u e s t i o n s
Myasthenia Gravis Q: What is myasthenia gravis (MG)? A: Myasthenia gravis (meye-uhss- THEEN-ee-uh GRAV uhss) (MG) is an autoimmune disease that weakens the muscles. The name comes from Greek and Latin
*A discrete, hypersensitive nodule within tight band of muscle or fascia that present with classic pattern of pain referral that does not follow
A patient presents with c/o cervical spine pain and chronic headaches that radiates across the top of his head. He also experiences frequent bouts of nausea, dizziness and indigestion. The patient also
Headaches + Facial pain
Headaches + Facial pain Introduction: Each of us experienced sporadically/ chronically headache 40% worldwide population suffers with severe, disabling headache at least annually Common ailment Presenting
http://images.tutorvista.com/content/control5coordination/human5brain.jpeg!! 387
http://images.tutorvista.com/content/control5coordination/human5brain.jpeg!! 387! 388! http://my.fresnounified.org/personal/lygonza/gonzalez/neuron/neuron5synapse%20communication.png!! http://www.urbanchildinstitute.org/sites/all/files/databooks/2011/ch15fg25communication5between5neurons.jpg!!
Patient: A 65-year-old male who is a Medicare Part B beneficiary, whose testing was ordered by his internist
The following examples are to assist you with PQRS reporting. These examples were created in collaboration with the Academy of Doctors of Audiology and the American Speech-Language-Hearing Association
Management Approach to Isolated Ocular Motor Nerve Palsies
Management Approach to Isolated Ocular Motor Nerve Palsies Alfredo A. Sadun, MD, PhD Thornton Professor of Vision Doheny Eye Institute Departments of Ophthalmology and Neurosurgery Keck/USC School of Medicine
Pseudoabducens palsy: When a VI nerve palsy is not a VI nerve palsy
Pseudoabducens palsy: When a VI nerve palsy is not a VI nerve palsy Emily S. Birkholz, MD, and Michael Wall, MD December 30, 2009 CC: 44 year old male with diplopia HPI: This 44 year old man with a history
1/26/2011. 50% of deafness and hearing impairment is avoidable through prevention, early diagnosis, and management.
Hearing Impairment Roseann Mulligan, DDS, MS Herman Ostrow School of Dentistry of the University of Southern California 1 JAMA, July 4, 2007 Vol 298, No. 1 2 278 million - moderate to profound bilateral
Benign Paroxysmal Positional Vertigo: Management and Future Directions
UNIVERSITY OF SIENA PhD PROGRAM IN BIOMEDICINE AND IMMUNOLOGICAL SCIENCES CYCLE XXIV Benign Paroxysmal Positional Vertigo: Management and Future Directions Tutor: Chiar. mo Prof. Daniele Nuti PhD Student:
DIAGNOSIS AND TREATMENT OF BPPV FOR PHYSICAL THERAPY
DIAGNOSIS AND TREATMENT OF BPPV FOR PHYSICAL THERAPY DISCLOSURES JAMES R. BARSKY PT, DPT CHESTNUT HILL HOSPITAL NEUROLOGY, PSYCHIATRY AND BALANCE THERAPY CENTER None Pennsylvania Physical Therapy Association
Eye Movement Abnormalities in Multiple Sclerosis
Eye Movement Abnormalities in Multiple Sclerosis Sashank Prasad, MD a, *, Steven L. Galetta, MD b KEYWORDS Multiple sclerosis Eye movement abnormalities Neuroanatomy Neuroimaging Multiple sclerosis (MS)
St. Luke s MS Center New Patient Questionnaire. Name: Date: Birth date: Right or Left handed? Who is your Primary Doctor?
St. Luke s MS Center New Patient Questionnaire Name: Date: Birth date: Right or Left handed? Who is your Primary Doctor? Who referred you to the MS Center? List any other doctors you see: Reason you have