Topic #2 - Are you performing the most efficient assessment based on the information from the case history and physical exam?

This newsletter series will explain how you can achieve vast time savings and yet gain more confidence in the diagnosis of the patient suffering from the most frequently diagnosed peripheral disorders. The goal of assessing the patient with vestibular symptoms is to determine if the disorder is unilateral or bilateral, what end organ is contributing to the disorder and the severity of the disorder, and assessing recovery after the onset of the disorder.

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Case History

Prolonged severe rotational vertigo, head movement worsens the symptoms,
postural imbalance to the side of the lesion, nausea 

Physical Exam & Spontaneous
Spontaneous horizontal nystagmus beating toward the left ear.

Impulse

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VEMP
cVEMP:
Reduction of amplitude on affected side.
(It should be noted that in the fields of neurology and neurophysiology convention is to have N1 (e.g. p13) as a downward deflection and N1 (i.e. n23) as an upwards deflection i.e. the reverse of what is shown below).

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oVEMP:
Within normal limits

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What is the Diagnosis?

  1. Meniere’s Disease
  2. Superior Vestibular Neuritis
  3. Vestibular Migraine
  4. Inferior Vestibular Neuritis
Learn more
Diagnostic booklet – Describing the global trend in vestibular testing 
Reimbursement for Vestibular Testing – US version – Current avg. reimbursement reported is $65
Why vHIT – Dr. Ian Curthoys
Analysis video

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