Vestibular Rehabilitation Flashcards

Which semicircular canal is most commonly affected in benign paroxysmal positional vertigo (BPPV)?

Answer: Posterior semicircular canal

The posterior semicircular canal is affected in approximately 85–90% of BPPV cases due to its anatomical orientation making it most susceptible to canalith accumulation when upright.

The Dix-Hallpike test is the gold standard for diagnosing BPPV affecting which canal?

Answer: Posterior semicircular canal

The Dix-Hallpike maneuver positions the posterior semicircular canal in the plane of gravity, provoking characteristic upbeat-torsional nystagmus when canaliths are displaced into that canal.

What type of nystagmus is characteristic of posterior canal BPPV when performing the Dix-Hallpike test?

Answer: Upbeat-torsional nystagmus beating toward the affected ear

Posterior canal BPPV produces upbeat-torsional nystagmus beating toward the affected (lowermost) ear due to ampullofugal deflection of the cupula by displaced canaliths.

The Epley canalith repositioning maneuver for posterior canal BPPV guides canaliths from the posterior semicircular canal back into the:

Answer: Utricle

The Epley maneuver uses four sequential head positions to move free-floating canaliths (otoconia) out of the posterior semicircular canal and back into the utricle where they cannot cause symptoms.

The head impulse test (Halmagyi-Curthoys test) assesses the integrity of which reflex?

Answer: Vestibulo-ocular reflex

The head impulse test detects VOR deficits by observing whether corrective catch-up saccades occur after a rapid, small-amplitude horizontal head thrust toward each side.

A patient with acute unilateral vestibular neuritis would most likely demonstrate which finding on examination?

Answer: Positive head impulse test when the head is thrust toward the affected side

Unilateral vestibular neuritis causes ipsilesional VOR deficit, resulting in a positive head impulse test (visible corrective saccade) when the head is rapidly thrust toward the lesioned side.

Which characteristic distinguishes peripheral vestibular nystagmus from central vestibular nystagmus?

Answer: It is direction-fixed and suppressed by visual fixation

Peripheral vestibular nystagmus is direction-fixed (fast phase does not change direction with gaze) and is suppressed by visual fixation, distinguishing it from central causes.