NCS Vestibular Rehabilitation

Question 1

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

Accepted Answer

Posterior semicircular canal

Answer

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.

Question 2

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

Accepted Answer

Posterior semicircular canal

Answer

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.

Question 3

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

Accepted Answer

Upbeat-torsional nystagmus beating toward the affected ear

Answer

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

Question 4

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

Accepted Answer

Utricle

Answer

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.

Question 5

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

Accepted Answer

Vestibulo-ocular reflex

Answer

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.

(NCS) Neurologic Clinical Specialist Practice Test

(NCS) Neurologic Clinical Specialist Practice Test

NCS Vestibular Rehabilitation