Vestibular Disorders

SPA 6317

VESTIBULAR DISORDERS

Spring 2006

Sect # 8050

Course Meets: Th.10:40 to 12:35 Instructor: Scott K. Griffiths, Ph.D.

In Weimer 1076 Office: 339 Dauer Hall Office Hrs: W 8:30-11:30 F 10:40-1:40 and by appt.

e-mail:

tel. 392-2113 ext 248

GOAL OF THIS COURSE: Students in this course will gain an understanding of how humans maintain balance, the contribution of the inner ear to balance, disorders of balance, and approaches to rehabilitation of these disorders.

Behavioral Objectives. Students completing this course will be able to:

1)Identify and describe all of the sensory systems involved in balance

2)Identify 6 items from a case history interview that are important to the management of a balance complaint.

3)Complete and describe significance of the results from the following tests:

1. Ocular motility
2. Stepping Fukuda
3. Halmagyi Head thrust
4. Modified CTSIB
5. Romberg
6. Dix-Hallpike maneuver

4)Identify the strengths and weaknesses of each of the following assessment procedures with 80% accuracy:

1. Oculomotor testing using ENG/VNG
2. Positional testing using ENG/VNG
3. Caloric Testing using ENG/VNG
4. Rotational testing
5. Posturographic testing

4) Correlate case history information and diagnostic results and name appropriate management steps with 80% accuracy.

5)Describe the procedures for management of BPPV with 90% accuracy.

Readings:

Primary Text: Desmond, A.L. Vestibular Function: Evaluation and Treatment. 2004. New York: Thieme. ISBN 1-588890-166-1

OtherReadings will be assigned out of the following texts made available to the class:

JNK = Jacobson, G.P., Newman, C.W. & Kartush, J.M. Handbook of Balance Function Testing

Chs 3, 5,6,7,8 & 9

S&T = Shepard, N.T.Telian, S.A. Practical Management of the Balance Disorder Patient

Ch 6

G = Goebel, J.A. Practical Management of the Dizzy Patient

Chs 16 & 17

SCHEDULE OF TOPICS:READINGS:

Intro/Basic Anatomy & PhysiologyChs 1&2

JNK Ch3 (Carl: Practical A&P-Ocular Motor Sys)

Case History & Physical ExamCh 3

EvaluationChs 3-4

ENG

Ocular-Motor JNK chs 5-6 (Hain: Ocular Motility Testing)

Positional TestingJNK chs 7 (Brandt: Positional/Positioning)

Caloric TestingJNK chs 8-9 (Jacobson et al: Caloric Testing)

Rotational TestingS&T Ch 6 (Rotational Chair Testing)

Posturography

Imaging and SerologyG Chs 16-17 (Wippold: Imaging; Hughes: Serology)

Treatment ProtocolsCh. 6

Balance Clinic OperationsChs 7-8

Lab Activities: Dr. Griffiths will be available in the UFSHC at selected times to supervise laboratory experiences. Students may sign up for these times. Activities will include screening tests, the VNG battery, and posturographic testing.

Grading: There will be one lab assignment, three disorder summary papers, two quizzes and one final exam in this course. As part of the disorders papers, students will be asked to make brief presentations during the final weeks of the class. Course grades (A95,B+88, B82,C75,D65, E<65) will reflect the following weighting:

Item:Due:Weighting:

LabApril 19th25 pts

Disorder Papers April 13th20 pts

Quiz 1Feb 9th15 pts

Quiz 2 March 30th15 pts

FinalMay 2 (12:30 pm)25 pts

Academic Honesty Policy

Academic dishonesty in any form will not be tolerated. Students suspected of violating the University’s policies on academic honesty will be dealt with in accordance with procedures outlined by the Office of Student Judicial Affairs. If you have not done so already, please familiarize yourself with the University's policy on academic dishonesty.

Cheating. The improper taking or tendering of any information or material, which shall be used to determine academic credit. Taking of information includes, but is not limited to, copying graded homework assignments from another student; working together with another individual(s) on a take-home test or homework when not specifically permitted by the teacher; looking or attempting to look at another student's paper during an examination; looking or attempting to look at text or notes during an examination when not permitted. Tendering of information includes, but is not limited to, giving your work to another student to be used or copied; giving someone answers to exam questions either when the exam is being given or after taking an exam; giving or selling a term paper or other written materials to another student; sharing information on a graded assignment.

Plagiarism. The attempt to represent the work of another as the product of one's own thought, whether the other's work is published or unpublished, or simply the work of a fellow student. Plagiarism includes, but is not limited to, quoting oral or written materials without citation on an exam, term paper, homework, or other written materials or oral presentations for an academic requirement; submitting a paper which was purchased from a term paper service as your own work; submitting anyone else's paper as your own work.

Bribery. The offering, giving, receiving, or soliciting any materials, items or services of value to gain academic advantage for yourself or another.

Misrepresentation. Any act or omission with intent to deceive a teacher for academic advantage. Misrepresentation includes using computer programs generated by another and handing it in as your own work unless expressly allowed by the teacher; lying to a teacher to increase your grade; lying or misrepresenting facts when confronted with an allegation of academic honesty.

Conspiracy. The planning or acting with one or more persons to commit any form of academic dishonesty.

Fabrication. The use of invented or fabricated information, or the falsification of research or other findings with the intent to deceive for academic or professional advantage.

Special Needs and Counseling Services

The University of Florida, under the guidelines of ADA and 504 federal legislation, is required to make reasonable accommodations to the known physical and mental limitations of otherwise qualified individuals with disabilities.
To help provide the best possible service to students, staff, faculty and visitors, the University of Florida has an Americans with Disabilities Act Office with a coordinator responsible for access for persons with disabilities. The ADA coordinator assists anyone with questions about access.

See for more information

Other resources:

Campus Alcohol and DrugResourceCenter (302 Student Health Center, 392-1161, ext. 4281).

UniversityCounselingCenter (301 Peabody Hall, 392-1575)

Student Mental Health Services (245 Student Health Center, 392-1171).

BALANCE DISORDERS TOPICS:

Endolymphatic Hydrops
Autoimmune Inner Ear Disease
Canalithiasis/Cupulolithiasis
Cerebellar infarction
Vestibular Ototoxicity
Allergic Balance difficulties
Glomus Jugulare
Parkinsonism
Orthostatic Hypotension
Vestibular Neuritis
Positional Alcohol Nystagmus
Ocular Tilt Reaction
Acrophobia/Agoraphobia
Benign Paroxysmal Torticollis – Infancy
Vertebro-basilar Insufficiency
Viral encephalitis
INO& Multiple Sclerosis
Balance Disorders related to polyneuropathy
Crisis of Tumarkin
Vestibular Atelectasis
Migraine
Mal de Debarquement
Arnold Chiari Syndrome
Vestibular Schwannoma
Baro-/Surgical trauma & Perilymph Fistula
Vertiginous Epilepsy
Cervical Vertigo
Motion Sickness
Vestibular Labyrinthitis
TIA and Stroke-related balance disorders
Waldenström’s Disease
Familial Periodic Ataxia/Vertigo
Space Adaptation Phenomenon
Head-extension Vertigo
Positional Glycerol nystagmus
Wallenberg’s Syndrome
Vestibular Aging
Paget’s Disease
Diabetes

VESTIBULAR LAB ASSIGNMENT:

Part 1) VNG LAB:

Complete test battery and interpret the results of testing on 2 subjects. The battery should include sinusoidal tracking, saccade, optokinetic nystagmus, Dix-Hallpike, positional, and caloric testing.

Grading Rubric:

Clean tracings/measures on 5 tests (Dix-Hallpike excluded):15 pts

Accurate Description of findings on 6 tests:30 pts

Accurate Interpretation of findings on 6 tests:15 pts

Part 2) POSTUROGRAPHY LAB:

Complete modified CTSIB, Limits of Stability, and Rhythmic Weight Shift tests on 2 people, and print out and interpret results.

Grading Rubric:

Clean tracings/measures on 3 tests:10 pts

Accurate Description of results on 3 tests:15 pts

Accurate Interpretation of findings on 3 tests:15 pts

Total Possible points:100

LAB SIGN UP SCHEDULE: (all labs in Dauer Hall 458)