CVT Assessment & Diagnosis of Vestibular Disorders 3

Question 1

During the Dix-Hallpike test for posterior canal BPPV, the characteristic nystagmus has which direction?

Accepted Answer

Upbeat-torsional toward the affected (down) ear

Answer

Posterior canal BPPV produces upbeat-torsional nystagmus with the torsional component beating toward the undermost (affected) ear during Dix-Hallpike.

Question 2

A patient complains of vertigo that is provoked by rolling from supine to left lateral decubitus but NOT by Dix-Hallpike. The MOST likely diagnosis is:

Accepted Answer

Horizontal canal BPPV

Answer

The roll test (Pagnini-McClure) provokes horizontal canal BPPV, which is not consistently elicited by the Dix-Hallpike maneuver.

Question 3

Skew deviation on the HINTS exam suggests pathology in which structure?

Accepted Answer

Brainstem otolithic pathways (central)

Answer

Skew deviation (vertical misalignment of the eyes) reflects disruption of central otolithic pathways in the brainstem or cerebellum, indicating central pathology.

Question 4

On dynamic posturography, a patient who falls only on Condition 6 (sway-referenced surface AND eyes closed) has difficulty with:

Accepted Answer

Isolated vestibular system use for balance

Answer

Condition 6 removes reliable visual and somatosensory input, forcing exclusive reliance on vestibular cues; failure indicates vestibular system deficit.

Question 5

The 'ice water caloric' test performed at bedside uses 0–4°C water to assess:

Accepted Answer

Brainstem integrity and vestibulo-ocular pathways in comatose patients

Answer

Ice water caloric irrigation in comatose patients assesses the integrity of brainstem VOR pathways when standard testing is not possible.

(CVT) Certified Vestibular Therapist Practice Test

(CVT) Certified Vestibular Therapist Practice Test

CVT Assessment & Diagnosis of Vestibular Disorders 3