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Title | Description | Type |
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Zuma Maneuver for Right Horizontal Canal Cupulolithiasis (Apogeotropic Nystagmus) | The Zuma Maneuver is used to treat horizontal canal cupulolithiasis (apogeotropic nystagmus). 1. The patient begins in a seated position. 2. The patient transitions quickly to lying position on their affected side, with their head in neutral, and maintains this position for three minutes. 3. The pat... | Text |
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Liberatory or Modified Semont, Posterior Canal Benign Paroxysmal Positional Vertigo (BPPV) for Right Posterior Canal BPPV (Canalithiasis or Cupulolithiasis) | Posterior canal (PC) accounts for 70-90% cases of BPPV [1-3] and resolves with canalith repositioning maneuvers 90% of the time [4-13]. The Semont/Liberatory maneuver is considered a gold-standard treatment, with class 1 evidence for use and success rates close to 90% [4-13].The Liberatory maneuver ... | Text |
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Li Maneuver for Geotropic Right HC-BPPV, Canalithiasis | The Li maneuver is used to treat horizontal canal, canalithiasis. When compared to the Gufoni maneuver, the Li maneuver was as effective to treat HC-BPPV and there was no significant difference between the maneuvers; however, the Li Maneuver may take less time to complete. 1. The patient starts in a... | Text |
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Gufoni Maneuver for Left Horizontal Canal BPPV, Canalithiasis (Geotropic Nystagmus) | The Gufoni maneuver may be preferable to the BBQ roll, as the Gufoni maneuver does not require the individual to roll or be in a prone position, making the maneuver more feasible to complete for individuals who are elderly, obese and/or experience immobility. Antecedently, some clinicians remember t... | Text |
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Brandt-Daroff Exercises | Brandt-Daroff exercises are less effective than the Epley and the Semont maneuvers and are not shown to prevent recurrence [1-3]. Brandt-Daroff exercises may still be beneficial for habituation exercises and to reduce phobic responses to lying supine or side-lying after the resolution of BPPV. This ... | Text |
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BBQ Roll for Right Horizontal Canal BPPV, Canalithiasis (Geotropic Nystagmus) | The BBQ Roll/Lampert Maneuver has been shown to be an effective treatment and is supported by a level I classification study. 1. The patient starts in a supine position with the head positioned 30 degrees above the horizon. 2. While maintaining head elevation, the patient's head (or whole body) is r... | Text |
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Semicircular Pathways | Once the semicircular canal fibers leave the peripheral labyrinth, they synapse in the ipsilateral vestibular nucleus, and then ascend to the ocular motor nuclei. This enables the vestibulo-ocular reflex to respond to head movements in the plane of any canal or combination of canals. | Text |
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Vertical Semicircular Canal Pathways | Anterior Canal Pathway Afferents that originate in the anterior canals (AC) of the peripheral labyrinth first synapse in the ipsilateral vestibular nucleus. Three pathways exist: 1) medial longitudinal fasciculus (MLF) - right AC afferents to right medial vestibular nucleus (MVN), decussate and asc... | Image |
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Approach to the Ocular Motor and Vestibular History and Examination | History and examination of ocular motor and vestibular. | Text |
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The Most Common Vestibular Conditions Categorized by Timing and Triggers, with Specific Historical Features that Should be Sought for Each (Adapted from Approach to the Ocular Motor and Vestibular History and Examination) | Adapted from https://collections.lib.utah.edu/ark:/87278/s64x9bq1 | Text |
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Atypical PC BPPV Variant Figures | Figure 1: Atypical posterior canal BPPV variants The labyrinth consists of the cochlea (C), two otolithic organs including utricle (U) and saccule (S), and three semicircular canals including anterior canal (AC), horizontal canal (HC), and posterior canal (PC). A. If otoconia are located within the ... | Image |
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Secondary Stroke Prevention | A brief overview of secondary stroke prevention. (TIA = Transient Ischemic Attack) | Text |
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Basics of Acute Stroke Treatment | A brief overview of management of acute stroke treatment. | Text |
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Expanded Nystagmus & Saccadic Intrusions/Oscillations Differential | Expanded nystagmus & saccadic intrusions/ oscillations differential | Text |
40 |
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Maddox Rod and Red Glass Testing | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: Describing the basics of strabismus. | Text |
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ENG, VNG, & VOG | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: Electronystagmography (ENG), and videonystagmography (VNG) or videooculography (VOG) are a collection of tests of eye movements that are performed either using surface electrodes around the eye (ENG) or with video goggles... | Text |
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Video Head Impulse Testing | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: The video head impulse test (vHIT) is a clinical assessment technique used to assess the function of the semicircular canals-the angular acceleration detectors-which initiate the vestibulo-ocular reflex (VOR). The HIT and... | Text |
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Audiometry | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: Audiometry is the measurement of the sensitivity and range of an individual's hearing. As many etiologies of imbalance, nystagmus, vertigo and/or dizziness can have an otologic origin the audiogram is an important piece o... | Text |
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Rotary Chair Testing | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: Rotary chair testing includes rotation around a vertical axis, and evaluates the horizontal semicircular canal vestibulo-ocular reflex (VOR). The patient sits in a mechanized chair with the head secured in a neutral posi... | Text |
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Vestibular Evoked Myogenic Potentials (VEMPs) | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: Vestibular-evoked myogenic potentials (VEMP) are electromyographic potential reflex tests that reflect the function of the saccule in cervical VEMP and the utricle in ocular VEMP.1 In the cervical VEMP an inhibitory refle... | Text |
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Caloric Testing | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: Caloric testing is a peripheral vestibular test which takes advantage of the fact that the labyrinth is sensitive to temperature changes. Warm stimulation causes excitation of the semicircular canals while cold stimulatio... | Image/MovingImage |
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Summary of the Most Common Audio-Vestibular Testing | Chart describing common audio-vestibular testing. | Text |
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Audiometry: What Does It Look Like and How Do I Interpret It? | An audiogram measures a patient's auditory threshold responses with pure-tone stimuli across a range of sound frequencies that are important for human communication, typically 250 Hz to 8000 Hz. The threshold is the sound intensity level at which an individual detects the tone 50% of the time. Heari... | Text |
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What is the Cause of My Patient's Hearing Loss? | This is a flowsheet differentiating multiple causes of hearing loss. The onset and chronicity of hearing loss is a critical starting point in understanding whether urgent action is needed, such as in the setting of suspected stroke or sudden sensorineural hearing loss. For hearing loss that has been... | Text |