Balance Function Tests

3.4.1 Discuss the basic battery of physical exam tests for a patient with vertigo/disequilibrium.

3.4.2 What are the mechanisms by which the body determines balance?

3.4.3 Make clinical distinctions between central and peripheral nystagmus.

3.4.4 Explain the origin of the fast and slow components of nystagmus.

3.4.5 How are calorics performed? What is the physiology behind them? How do you interpret them?

3.4.6 Tell us about electronystagmography (ENG). Give examples and how to interpret them. Make sure to include labeling conventions.

3.4.7 Explain the VOR pathway--Don't skimp on the anatomy. Explain how the orientation of the vestibular organs is relevant.

3.4.8 Explain the physiology of benign paroxysmal positional vertigo (BPPV). What are the medical and surgical options?

3.4.9 Give the differential diagnosis of vertigo, separate each by symptom duration and onset.

3.4.10 What does a rotary chair measure? Explain phase, gain and what would cause abnormalities in these?

3.4.11 What does posturagraphy test for? What is its usefulness?

Monsell EM, Furman JM, Herdman SJ, Konrad HR, Shepard NT. Computerized dynamic platform posturography. Otolaryngol Head Neck Surg. 1997 Oct;117(4):394-8. PMID:9339802

3.4.12 Discuss the subjective visual horizontal test and its’ clinical utility.

Karlberg M, Aw ST, Halmagyi GM, Black RA. Vibration-induced shift of the subjective visual horizontal: a sign of unilateral vestibular deficit. Arch Otolaryngol Head Neck Surg. 2002 Jan;128(1):21-7. PMID:11784249

3.4.13 What is a VEMP? What is its usefulness?

Brantberg K. Vestibular evoked myogenic potentials (VEMPs): usefulness in clinical neurotology. Semin Neurol. 2009 Nov;29(5):541-Epub 2009 Oct 15. PMID:19834866