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    Add as FriendAssessment of vestibular function ppt by Dr Manas

    by: Dr Manas Ranjan Rout

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    1 : Assessment Of Vestibular Function Dr Manas 1
    2 : Clinical tests Laboratory tests 2
    3 : Spontaneous Nystagmus Fistula test Romberg test Gait Past-pointing and Falling Hallpike Maneuver (Positional test) Tests for Cerebellar dysfunction Clinical tests 3
    4 : It is involuntary, rhythmical, oscillatory movement of eye It may be horizontal, vertical or rotatory Peripheral – Labyrinth, VIII nerve Central – Vestibular nucleus, Brain stem, Cerebellum Spontaneous Nystagmus 4
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    7 : Inducing nystagmus by producing pressure changes in the external canal. Positive in fistula in round window, oval window, lateral canal false positive in – Congenital syphilis, Meniere’s disease Fistula test 7
    8 : Procedure Perepheral lesion – pt sways to the side of lesion Central lesion – Pt unstable Romberg Test 8
    9 : Pt asked to walk on straight line to a fixed point, first with eye open and then closed. With eye closed pt deviated to affected side in peripheral vestibular lesion. Gait test 9
    10 : Past pointing, falling and slow component of the nystagmus are all in same direction ie. In the direction of acute vestibular failure. Past pointing and falling 10
    11 : Hallpike Maneuver(Positional test) 11
    12 : Disease of Cerebellar hemisphere Asynergia (Abnormal finger nose test) Dysmetria (Inability to control the range of motion) Dysdiadokokinesia (Inability to perform the rapid alternating movement) Rebound phenomenon Midline disease Wide base gait, truncal ataxia Falling in one direction Inability to turn suddenly Test for Cerebellar dysfunction 12
    13 : Caloric test Modified Kobrak test Bithermal caloric test Cold air caloric test Electronystagmography Optokinetic test Rotation test Galvanic test Posturography Laboratory tests 13
    14 : OPD procedure Pt head tilted 60° backward Ear irrigated with ice water for 60 sec 5ml ? 10ml ? 20ml ? 40ml. No response at 40 ml ? Dead labyrinth Modified Kobrak test 14
    15 : pt head tilted 300 forwards and ears irrigated alternatively with 30 and 440c for 40sec Fitzgerald – Hallpike test (Bithermal caloric test) 15
    16 : Cold irrigation – Nystagmus to opposite side Warm irrigation – Nystagmus to same side 16
    17 : Canal paresis – Response decreased on one side for both cold and warm water Directional preponderance – Response will be towards one side whether it is coming from right or left ear. Results 17
    18 : THANK YOU 18

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