ABI- Vestibular- Exam and Treatment Questions and Answers Graded A+
Dizziness Handicap Inventory (DHI) - Answers25 questions
3 domains: physical, emotional, functional
yes=4 points, sometimes=2 points, no=0 points
0-39=low perception of handicap
70-100=severe perception of handicap
Activities Specific Balance Confidence scale (ABC) - Answers16 questions
rate confidence when completing various tasks
0=no confidence
100=complete confidence
symptoms, tempo, circumstance - Answers3 key components of patient history
smooth pursuit test - Answersoculomotor test of CN III, IV, VI
eyes follow tip of finger as you move it slowly up/down and L/R
abnormal: pt loses target, catches up with saccades (small corrective beats)
saccades test - Answersoculomotor test
quickly look back and forth between nose and finger about 12 inches apart
abnormal: slow saccades, overshooting/undershooting, latent onset
dynamic visual acuity test - Answersvestibulo-ocular control test
read wall chart with (1) head stationary, (2) head passively rotated side to side at 2 Hz
(+): drop in acuity of more than 2-3 lines = difficulty with gaze stability (VOR)
head thrust test - Answersvestibulo-ocular control test
pitch head down 30°, pt fixates on nose, rapidly move head side to side
(+): movement of pupil (corrective saccade) after thrust
can be unilateral or bilateral
Dix Hallpike Test - Answers1: long sitting, head turned 45° to side
, 2: rapidly bring to supine with head in 30° extension (hanging off table)
observe for nystagmus (direction) and vertigo (onset and resolution)
can determine canalithiasis or cupulolithiasis
Roll Test - Answers1: supine in Dix Hallpike position, then passively flex head up 20-30°
2: quickly roll head to less suspected side, hold for 1 min
3: slowly roll to midline, then to other side x 1 min
symptoms will be worse toward involved side but will occur bilaterally
BPPV test sequence - Answers1: Dix Hallpike to suspected non-affected side
2: Dix Hallpike to suspected affected side
3: Roll Test to suspected non-affected side
4: Roll Test to suspected affected side
Motion Sensitivity Score - Answersmeasures motion-provoked dizziness, 16 items
each position rated 0 (no symptoms) to 5 (severe symptoms)
calculate cumulative score + motion sensitivity quotient
31-100 = severe motion sensitivity
vergence system dysfunction - Answersinability to turn eyes inward to focus on near target
can be insufficient (reduced) or spasm (increased)
symptoms: difficulty focusing, reading, blurry vision, headache, eye strain
tropia - Answerstype of ocular alignment dysfunction, present at rest
symptoms: double vision, headache, difficulty focusing
eye deviates to one side: can be exo (outward), eso (inward), hyper (upward), hypo (downward)
phoria - Answerstype of ocular alignment dysfunction, not apparent unless eye covered
symptoms: double vision, headache, difficulty focusing
eye deviates to one side: can be exo (outward), eso (inward), hyper (upward), hypo (downward)
cover-uncover test - Answers1: cover one eye
Dizziness Handicap Inventory (DHI) - Answers25 questions
3 domains: physical, emotional, functional
yes=4 points, sometimes=2 points, no=0 points
0-39=low perception of handicap
70-100=severe perception of handicap
Activities Specific Balance Confidence scale (ABC) - Answers16 questions
rate confidence when completing various tasks
0=no confidence
100=complete confidence
symptoms, tempo, circumstance - Answers3 key components of patient history
smooth pursuit test - Answersoculomotor test of CN III, IV, VI
eyes follow tip of finger as you move it slowly up/down and L/R
abnormal: pt loses target, catches up with saccades (small corrective beats)
saccades test - Answersoculomotor test
quickly look back and forth between nose and finger about 12 inches apart
abnormal: slow saccades, overshooting/undershooting, latent onset
dynamic visual acuity test - Answersvestibulo-ocular control test
read wall chart with (1) head stationary, (2) head passively rotated side to side at 2 Hz
(+): drop in acuity of more than 2-3 lines = difficulty with gaze stability (VOR)
head thrust test - Answersvestibulo-ocular control test
pitch head down 30°, pt fixates on nose, rapidly move head side to side
(+): movement of pupil (corrective saccade) after thrust
can be unilateral or bilateral
Dix Hallpike Test - Answers1: long sitting, head turned 45° to side
, 2: rapidly bring to supine with head in 30° extension (hanging off table)
observe for nystagmus (direction) and vertigo (onset and resolution)
can determine canalithiasis or cupulolithiasis
Roll Test - Answers1: supine in Dix Hallpike position, then passively flex head up 20-30°
2: quickly roll head to less suspected side, hold for 1 min
3: slowly roll to midline, then to other side x 1 min
symptoms will be worse toward involved side but will occur bilaterally
BPPV test sequence - Answers1: Dix Hallpike to suspected non-affected side
2: Dix Hallpike to suspected affected side
3: Roll Test to suspected non-affected side
4: Roll Test to suspected affected side
Motion Sensitivity Score - Answersmeasures motion-provoked dizziness, 16 items
each position rated 0 (no symptoms) to 5 (severe symptoms)
calculate cumulative score + motion sensitivity quotient
31-100 = severe motion sensitivity
vergence system dysfunction - Answersinability to turn eyes inward to focus on near target
can be insufficient (reduced) or spasm (increased)
symptoms: difficulty focusing, reading, blurry vision, headache, eye strain
tropia - Answerstype of ocular alignment dysfunction, present at rest
symptoms: double vision, headache, difficulty focusing
eye deviates to one side: can be exo (outward), eso (inward), hyper (upward), hypo (downward)
phoria - Answerstype of ocular alignment dysfunction, not apparent unless eye covered
symptoms: double vision, headache, difficulty focusing
eye deviates to one side: can be exo (outward), eso (inward), hyper (upward), hypo (downward)
cover-uncover test - Answers1: cover one eye
