ABA ABA Vestibular & Balance Assessment 1 — Questions and Answers
Question 1: Which test is considered the gold standard for evaluating semicircular canal function in vestibular assessment?
- Dix-Hallpike maneuver
- Video Head Impulse Test (vHIT)
- Caloric irrigation testing (Correct answer)
- Rotary chair testing
Correct answer: Caloric irrigation testing
Caloric irrigation testing selectively stimulates each horizontal semicircular canal and is considered the gold standard for identifying unilateral vestibular weakness.
Question 2: The Dix-Hallpike maneuver is the primary diagnostic test for which vestibular disorder?
- Meniere's disease
- Benign Paroxysmal Positional Vertigo (BPPV) (Correct answer)
- Vestibular neuritis
- Superior semicircular canal dehiscence
Correct answer: Benign Paroxysmal Positional Vertigo (BPPV)
The Dix-Hallpike maneuver provokes the characteristic torsional-upbeat nystagmus associated with posterior canal BPPV.
Question 3: What does a canal paresis value greater than 25% indicate on caloric testing?
- Bilateral vestibular hypofunction
- Directional preponderance
- Unilateral vestibular weakness (Correct answer)
- Central vestibular lesion
Correct answer: Unilateral vestibular weakness
A canal paresis (Jongkees formula) exceeding 25% is considered significant and indicates reduced function on the weaker side.
Question 4: Which nystagmus characteristic most strongly suggests a central rather than peripheral vestibular lesion?
- Direction-fixed nystagmus
- Direction-changing gaze-evoked nystagmus (Correct answer)
- Nystagmus suppressed by visual fixation
- Unidirectional horizontal nystagmus
Correct answer: Direction-changing gaze-evoked nystagmus
Direction-changing gaze-evoked nystagmus (nystagmus that beats right on right gaze and left on left gaze) is a hallmark of central vestibular pathology.
Question 5: The video Head Impulse Test (vHIT) assesses function of which reflex?
- Cervico-ocular reflex
- Optokinetic reflex
- Vestibulo-ocular reflex (VOR) (Correct answer)
- Tonic vibration reflex
Correct answer: Vestibulo-ocular reflex (VOR)
vHIT measures the gain of the vestibulo-ocular reflex by detecting corrective saccades following rapid head impulses.
Question 6: During VEMP (Vestibular Evoked Myogenic Potential) testing, cervical VEMP (cVEMP) primarily assesses which end organ?
- Utricle
- Saccule (Correct answer)
- Posterior semicircular canal
- Horizontal semicircular canal
Correct answer: Saccule
cVEMP is an inhibitory response recorded from the sternocleidomastoid muscle and reflects saccular and inferior vestibular nerve function.
ABA ABA Vestibular & Balance Assessment 1
Which test is considered the gold standard for evaluating semicircular canal function in vestibular assessment?