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A. Thompson-Harvey and Y. Agrawal
assessment of vestibular compensation is lacking, vestibular physical therapists
have found improvements in functional patient outcomes by utilizing objective
measurements of dynamic visual acuity, which incorporate vestibular function and
compensation [75–78].
Personalized counseling on home modication, exercise programs, and the need
for assistive devices may be prescribed as needed by physical and occupational
therapy [79–82]. While trials of body-worn sensors show promise, the current systems are limited in identifying the context of mobility (e.g., walking occurred inside
or outside the home, limiting potential fall prediction) [83–86]. Further, vestibular
prosthetics have the potential to be a new technology for the treatment of presbyvestibulopathy [87, 88].
Summary
Vestibular function declines with age due to changes in peripheral and central mechanisms, manifesting as postural imbalance, gait impairment, and increased fall risk.
While BPPV is the most common form of dizziness presenting in the older adult,
the clinician should readily rule out any contributions from nonvestibular entities, as
multifactorial etiologies are common within this group. Among older adults with a
prolonged history of unsteadiness, dizziness, or recurrent falls, the clinical should
be sure to screen for underlying vestibular dysfunction and employ the presbyvestibulopathy diagnostic criteria where appropriate. Referrals to vestibular rehabilitation therapy and/or multidisciplinary clinics are critical to optimizing long-term
patient health.
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331
Index
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A
Abdominal migraine, 203, 210
Active psychiatric disorders, 230
Activities-specic Balance Condence scale
(ABC), 266
Acute autoimmune neuropathies, 93
Acute Menière’s attacks, 74
Acute peripheral vestibulopathies, 251
Acute unilateral peripheral vestibulopathy
(AUPVP), 91
Acute unilateral vestibular hypofunction, 268
Acute vestibular syndrome (AVS), 93,
188–189, 232–234, 236, 237, 239
Aging
epidemiology, 318
pathophysiologic changes, 319–321
Amifostine, 174
Anterior canal BPPV (A-BPPV), 127
Anterior vestibular artery supplies, 9–10
Anxiety disorders
balance symptoms, 249
panic attacks, 249, 253
primary and secondary causes, 249
treatment, 253
vestibular and balance function tests, 252
vestibular symptoms, 249
Anxiety-related personality traits, 247
Anxiolytic antidepressants, 258
Arterial supply, 9
Asymmetric gaze nystagmus, 37
Audiometry, 171–172
Augmented reality, 285
Autonomic dysfunction, 190
Autophony, 108
Avitene®, 111
B
Base line audiometric tests, 174
Basilar artery migraine, 201–203, 218
Bedside balance function tests, 322
Bedside tests, 29
Behavioral hypothesis, 251
Benign paroxysmal positional vertigo (BPPV),
30, 66, 91, 99, 109, 188, 202,
204, 205, 209, 210, 216, 251,
265, 269–278, 320, 323,
324, 326
clinical presentation, 126–128
controversies, 140
diagnostic dilemmas, 133
history, 121–123
management, 133–139
maneuvers for anterior canal, 138–139
physical examination, 128–133
physiology of, 124–126
prognosis, 139
relevant anatomy, 123
surgery, 140
Benign paroxysmal torticollis of infancy
(BPTI), 190
Benign paroxysmal vertigo of childhood
(BPVC), 190, 204
Benzodiazepines, 173
Bilateral vestibular hypofunction (BVH), 264,
268, 284, 285
Bilateral vestibulopathy (BV), 302, 303, 311
Bilateral weakness, 46
Bithermal caloric test, 43, 44, 46
Bony vestibular labyrinth, 1
Bow and lean test, 269, 275
Brandt-Daroff exercises, 273, 277
© The Editor(s) (if applicable) and The Author(s), under exclusive license to
Springer Nature Switzerland AG 2023
B. T. Crane et al. (eds.), Disorders of the Vestibular System,
https://doi.org/10.1007/978-3-031-40524-2
333
334
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Index
C
Calcitonin gene related peptide (CGRP), 206
Calcium carbonate otoconia, 16
Caloric test, 42, 45, 184, 185
Caloric vestibular testing, 42
Canalith jam, 128
Canalithiasis, 269, 273, 275
Cawthorne-Cooksey exercises, 247, 277
Central nervous system, 8
Central sensory sensitization theory, 206
Cervical vestibular evoked myogenic potential
(cVEMP), 25, 59, 252, 318, 320
CHARGE syndrome, 187
Chloramphenicol, 168
Cholesteatoma, 104
Cisplatin ototoxicity, 168
Cisplatin-induced ototoxicity, 175
Cogan’s syndrome, 188
Cognitive behavioral therapy, 239–242,
258, 279
in psychology and vestibular
rehabilitation, 247
Cognitive dysfunction, 210
Cognitive Failure Questionnaire, 210, 239
Compensatory saccadic exercises, 264
Computerized dynamic posturography (CDP),
55–57, 186, 325
Concussion, 272
Congenital cytomegalovirus (CMV), 187
Congenital ototoxicity, 169
Covert saccades, 53
C-reactive protein (CRP), 92
Crista ampullaris, 17–19, 22
Cupulolithiasis, 127
cVEMP waveform, 60
D
Dark cells, 6
Dehydrating agents, 76
Directional preponderance, 44
Disassociated (disconjugate) nystagmus, 37
Disequilibrium, 280–283, 322
Dix-Hallpike maneuver, 29, 128
Dix-Hallpike test, 269, 273
Dizziness, 105, 180, 201–205, 207, 209, 211,
214–218, 220, 222, 263–266, 268,
270, 272, 278, 279, 317,
318, 321–326
Dizziness handicap index, 312
Dizziness handicap inventory (DHI), 98, 112,
204, 215, 220, 222, 255, 256, 266
Dynamic gait index (DGI), 267, 312
Dynamic posturography, 171, 250, 252,
Dynamic visual acuity (DVA) test, 28,
Dysautonomia, 190
E
“Early” (primary) perilymph stula, 147, 148
Electrically evoked compound action
Electrocochleography, 75–76
Electronystagmography (ENG), 30–33,
Electrooculography (EOG), 31
Elicited cervical vestibular evoked myogenic
Endolymphatic hydrops, 68
Endolymphatic sac, 6
Enlarged vestibular aqueduct syndrome
Episodic vestibular disorders, 251
Epley maneuver, 134, 273–275
Erythromycin, 168
Exposure therapy, 278, 279
Extralabyrinthine approach, 306
Eye movements, 105
F
Failure of xation suppression (FFS), 47
Fall-related injuries, 264
Familial hemiplegic migraine, 208
18
F-uorodeoxy glucose-PET studies, 207
Fistula tests, 150
Frenzel glasses, 43
Frenzel or videonystagmography (VNG)
Functional gait assessment, 267, 283
Functional gait disorder, 250, 251, 256
Functional neurological disorder (FND), 191
Functional rehabilitation, 311
G
Gain-Time constant (GainTc), 319
Gaze stability, 267, 272, 279, 280, 283, 285
Gaze test, 36
Gelatin sponge, 149
Gelfoam®, 111
Generalized anxiety disorder, 250, 256
Generalized Anxiety Disorder Scale
253, 257
267, 280
potentials (eCAPs), 307, 312
35, 36, 150
potentials (ecVEMPs), 311
(EVAS), 104
goggles, 183
(GAD-7), 256
Index
https://t.me/medicina_free
335
Gentamicin, 79
Gentamycin ototoxicity, 30
Gluten sensitivity, 67
Gufoni (Vannucchi) maneuvers, 275, 277
Guillain-Barre syndrome, 93
H
Hallpike caloric tests, 150
Head impulse test (HIT), 28, 94, 183
Head thrust testing, 75
Hemiplegic migraine, 203
Herpes simplex type 1 (HSV1), 92
HINTS triad, 96
Home gaze stability exercise behavior, 325
Horizontal canal BPPV (H-BPPV), 127
Human labyrinth, 10
Human leucocyte antigens (HLA), 67
Hyperactive caloric responses, 47
Hyperacusis, 105
I
Incremental VOR adaptation (IVA) paradigm,
285, 286
Inner ear, 1
Intralabyrinthine approach, 305–307
Intraoperative measurements, 307, 308
Intratympanic injection, 80
INvestigating VESTibular Migraine Emgality
Treatment, 222
K
Knapp’s hypothesis, 64
L
Labyrinthectomy, 81
Labyrinthitis, 31, 43, 91, 189
Late (delayed or secondary) perilymphatic
stula, 149
Lateral semicircular canal dehiscence, 104
Lateral vestibulo-spinal tract
(LVST), 24
Local overpressure therapy, 78
Long-term prognosis, 98
M
Mal de debarquement syndrome (MdDS),
217, 272–273
Medial vestibulospinal tract (MVST), 24
Menière’s disease, 31, 43, 251, 253, 304, 310,
312, 313, 318, 323
clinical presentation, 65, 71–74
cochleosacculotomy, 64
diagnosis of, 71
endolymphatic drainage system, 68
etiology of, 70
hearing loss and tinnitus, 75
hearing loss and vertigo, 65
history, 74
incidence, 66–67
pathogenesis, 67–69
subarachnoid drainage, 64
trans-mastoid decompression, 64
transtympanic therapy, 64
treatment, 77–82
vertigo symptoms, 63
viral infection, 70
Middle ear dysfunction, 188
Migraine associated dizziness, 202
Migraine associated vertigo, 202
Migraine with brainstem aura, 201
Mindfulness based stress reduction (MBSR)
trial, 221
Minocycline, 168
Morris water maze test, 239
Multisection CT angiography, 160
N
N-acetylcysteine, 174
Neck manipulation, 156
Neural viability, 312
Neurokinin A, 206
Neuronal plasticity/reweighting
mechanisms, 325
Neurophysiologic hypothesis, 251
Niigata PPPD Questionnaire, 232, 233
Nystagmus, 95
O
Ocular tilt reaction (OTR), 95
Ocular VEMP (oVEMP), 59, 106
Oculomotor tests, 31
Older adult
vestibular compensation, 325–326
with vestibular loss, 324–326
evaluation of, 322–324
impact of, 321–322
vestibular rehabilitation, 325
Optokinetic nystagmus (OKN), 31, 36
Oscillopsia, 169, 265, 266, 268, 285
336
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Index
Otolith stimulation, 303, 312
Ototoxic drugs, 173
Ototoxicity, 31, 168–170, 173
Overt saccades, 53
P
Panic attacks, 191, 247, 249, 250, 253
Patient Health Questionnaire (PHQ-9), 256
Patulous Eustachian tube (PET), 107
Pediatric dizziness, 186
Pediatric vestibular disorders
accommodations and follow-up, 195–196
alternative therapies, 195
anatomy, 180–181
autonomic dysfunction, 190
BPPV, 188
dizziness history factors, 182
functional/psychological, 191–192
history, 181
indications for vestibular testing, 184
medication, 194
middle ear dysfunction, 188
neurological, 189–190
otological, 187–189
physical examination, 183
physiology and development, 180–181
school accommodations, 196
sensorineural hearing loss, 187–188
surgery, 194–195
vestibular rehabilitation, 192, 193
Perilymphatic stula (PLF), 108
audiometric evaluation, 150
biomarkers for, 155
cause of, 148–149
clinical examination of, 150
criteria to diagnose, 147
dened, 145
“early” (primary) perilymph stula,
147, 148
incidence, 147
late (delayed or secondary) perilymphatic
stula, 149
management of, 152
polyethylene strut, 146
post stapedectomy, 146
prevention, 151
radiological evaluation, 151
radiological imaging, 154–155
signs and symptoms of, 146–147
spontaneous perilymphatic stula,
153, 154
vestibular tests, 150–151
Peripheral blood mononuclear cells
(PBMCs), 93
Peripheral vestibular disorders, 64
Peripheral vestibular system
balance system, 2–6
endolymphatic sac and duct, 6–7
innervation, 7–9
vascular supply, 9–10
Persistent postural-perceptual dizziness
(PPPD), 186, 191–192, 216, 218,
268, 271, 286
core symptoms, 229
denition, 229
diagnosis, 230, 233
differential diagnosis, 234–236
epidemiology, 231, 232
factor analysis, 229
pathophysiologic mechanisms, 230,
231, 236
acute body vigilance and negative
perceptions of illness, 237
additional alterations in
functioning, 239
altered control of stance and gait, 237
anxiety diathesis (trait and state
variables), 236, 237
changes in brain activity and
connectivity, 238
visual dependence, 238
serotonin reuptake inhibitors, 240
treatment
medication, 240
psychotherapy, 240
vestibular rehabilitation, 239
Phylogenetics, 14
Plasma brinogen, 92
Polymyxin, 168
Positional nystagmus, 41
Positional testing, 40, 41
Post concussive syndrome, 218
Posterior semicircular canal dehiscence, 104
Postural orthostatic tachycardia syndrome, 233
Posturography, 57
Pre-existing anxiety diathesis, 253
Presbyvestibulopathy (PVP), 265, 318, 319,
322, 323, 325, 326
Psychiatric disorders
threat and anxiety, effects of, 248–249
with vestibular illnesses, 251
clinical history, 256
laboratory tests, 257
patient self-report
questionnaires, 255–256
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