ABA ABA Vestibular & Balance Assessment 2 — Questions and Answers
Question 1: Which finding on posturography (CDP) suggests a vestibular use pattern?
- Fall on conditions 1 and 2 only
- Fall on conditions 5 and 6 with intact 1–4 (Correct answer)
- Fall on all six conditions
- Normal performance on all conditions
Correct answer: Fall on conditions 5 and 6 with intact 1–4
Falling on conditions 5 and 6 (which require vestibular input) while maintaining balance on conditions 1–4 indicates a vestibular sensory organization deficit.
Question 2: What is the treatment of choice for posterior canal BPPV?
- Vestibular suppressant medication
- Surgical canal plugging
- Epley canalith repositioning maneuver (Correct answer)
- Brandt-Daroff exercises for acute relief only
Correct answer: Epley canalith repositioning maneuver
The Epley maneuver repositions displaced otoconia from the posterior semicircular canal back into the utricle and resolves BPPV in the majority of cases.
Question 3: Meniere's disease is classically characterized by which tetrad of symptoms?
- Tinnitus, aural fullness, sensorineural hearing loss, and episodic vertigo (Correct answer)
- Conductive hearing loss, otalgia, vertigo, and facial palsy
- Bilateral hearing loss, oscillopsia, tinnitus, and imbalance
- Vertigo, nystagmus, headache, and visual disturbance
Correct answer: Tinnitus, aural fullness, sensorineural hearing loss, and episodic vertigo
The classic Meniere's tetrad includes episodic vertigo lasting 20 minutes to 12 hours, fluctuating low-frequency sensorineural hearing loss, tinnitus, and aural fullness.
Question 4: Oscillopsia is most commonly associated with which vestibular condition?
- BPPV
- Meniere's disease
- Bilateral vestibular hypofunction (Correct answer)
- Vestibular migraine
Correct answer: Bilateral vestibular hypofunction
Bilateral vestibular hypofunction impairs the VOR, causing the world to appear to bounce or oscillate during head movement (oscillopsia).
Question 5: Which medication class is most commonly used as a vestibular suppressant during acute vertigo episodes?
- Aminoglycosides
- Anticholinergics and antihistamines (Correct answer)
- Diuretics
- Calcium channel blockers
Correct answer: Anticholinergics and antihistamines
Anticholinergics (e.g., scopolamine) and antihistamines (e.g., meclizine) are the primary vestibular suppressants used for symptomatic relief of acute vertigo.
Question 6: What does a significant directional preponderance (>30%) on caloric testing indicate?
- Unilateral weakness of the vestibular system
- Asymmetry in total nystagmus responses favoring one direction (Correct answer)
- Bilateral vestibular loss
- Normal vestibular function
Correct answer: Asymmetry in total nystagmus responses favoring one direction
Directional preponderance reflects an asymmetry in spontaneous or induced nystagmus intensity favoring one beat direction, which may indicate ongoing vestibular imbalance.
ABA ABA Vestibular & Balance Assessment 2
Which finding on posturography (CDP) suggests a vestibular use pattern?