scholarly journals Vestibular Physiotherapy Patients May Require Medical Assessment: Results of Vertigo Audit in Hutt Hospital

2021 ◽  
Author(s):  
Shyh Poh Teo
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
Medical Review ◽  
Medical Assessment ◽  
Medical Opinion ◽  
Positional Vertigo ◽  
Vestibular Assessment ◽  
Migraine Medication ◽  
Medication Optimization ◽  
Medication Changes ◽  
Paroxysmal Positional Vertigo

Introduction: To identify the type of referrals received by vestibular physiotherapists for vertigo and assess whether medical review for these patients would be appropriate. Materials and Methods: We performed a retrospective review of referral forms, vestibular assessment forms, and vertigo clinic letters of patients referred for vertigo or vestibular physiotherapy input between July 1, 2013, to December 31, 2013. Results:  We  studied 29 patients with a median age of 63 years. A diagnosis was provided  in 65.5% of the referrals. Of 14 patients with possible benign paroxysmal positional vertigo (BPPV), Dix-Hallpike had been performed only for 4 patients. Almost half were seen for the medical review in the Vertigo Clinic due to the concerns of possible alternative non-vestibular diagnosis, medication issues, or syncope. Alternative diagnoses identified medically included orthostatic hypotension, stroke, vestibular migraine, medication-induced bradycardia, and phobic postural vertigo. Medication changes in vertigo clinic included treatment for heart failure, migraine, and medication optimization. Conclusion: Medical review is appropriate for some patients referred for vestibular physiotherapy. A medical opinion should  be sought  by vestibular  physiotherapists  if there is uncertainty or concerns that the referred patients did not have straightforward vestibular problems, or there were possible alternative diagnoses, concerns with medications, or syncope.

The role of the vestibular assessment

2009 ◽  
Vol 123 (11) ◽  
pp. 1212-1215 ◽  
Author(s):  
J S Phillips ◽  
J E FitzGerald ◽  
A P Bath
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
Vestibular Rehabilitation ◽  
Careful Consideration ◽  
Test Results ◽  
Positional Vertigo ◽  
Vestibular Assessment ◽  
Dizzy Patient ◽  
Paroxysmal Positional Vertigo

AbstractObjective:To evaluate the role of vestibular assessment in the management of the dizzy patient.Materials and methods:A retrospective review of case notes and vestibular assessment reports of 100 consecutive patients referred for vestibular assessment.Results:Sixty of the 100 patients had an abnormal vestibular assessment. Eleven patients had benign paroxysmal positional vertigo as the sole diagnosis, of whom nine had not had a Dix–Hallpike manoeuvre performed before referral. Of patients referred for vestibular rehabilitation, 76 per cent had an abnormal electrophysiological assessment. After vestibular assessment, 35 patients were discharged with no further follow-up appointments in the ENT department.Conclusions:All patients should have a Dix–Hallpike manoeuvre performed prior to referral for vestibular assessment. The majority of our patients undergoing vestibular rehabilitation had abnormal test results, although a significant number did not. Prior to referral, it is worth considering the implication of a ‘normal’ and ‘abnormal’ result for the management of the patient. Careful consideration should be given to the development of dedicated dizziness clinics run by practitioners with a specialist interest in balance disorders, in order to ensure appropriate requests for vestibular assessment.

Clinical Implications of the Center of Balance for a Veteran with Traumatic Brain Injury

2015 ◽  
pp. 280-289
Keyword(s):  
Traumatic Brain Injury ◽  
Case Report ◽  
Brain Injury ◽  
Benign Paroxysmal Positional Vertigo ◽  
Medical Center ◽  
Treatment Plan ◽  
Successful Outcome ◽  
Model Case ◽  
Positional Vertigo ◽  
Paroxysmal Positional Vertigo

Background: It is known that traumatic brain injury (TBI), even of the mild variety, can cause diffuse multisystem neurological damage. Coordination of sensory input from the visual, vestibular and somatosensory pathways is important to obtain proper balance and stabilization in the visual environment. This coordination of systems is potentially disrupted in TBI leading to visual symptoms and complaints of dizziness and imbalance. The Center of Balance (COB) at the Northport Veterans Affairs Medical Center (VAMC) is an interprofessional clinic specifically designed for patients with such complaints. An evaluation entails examination by an optometrist, audiologist and physical therapist and is concluded with a comprehensive rehabilitative treatment plan. The clinical construct will be described and a case report will be presented to demonstrate this unique model. Case Report: A combat veteran with a history of a gunshot wound to the skull, blunt force head trauma and exposure to multiple explosions presented with complaints of difficulty reading and recent onset dizziness. After thorough evaluation in the COB, the patient was diagnosed with and treated for severe oculomotor dysfunction and benign paroxysmal positional vertigo. Conclusion: Vision therapy was able to provide a successful outcome via improvement of oculomotor efficiency and control. Physical therapy intervention was able to address the benign paroxysmal positional vertigo. The specific evaluation and management as pertains to the aforementioned diagnoses, as well as the importance of an interprofessional rehabilitative approach, will be outlined.

scholarly journals Benign Paroxysmal Positional Vertigo Treated with Maneuvers to Change Head Position.

1995 ◽  
Vol 88 (7) ◽  
pp. 857-862
Author(s):  
Takayoshi ITAYA ◽  
Hiroya KITANO ◽  
Yoshiro YAZAWA ◽  
Akira KODAMA ◽  
Ichiro KOMADA ◽  
...  
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
Head Position ◽  
Positional Vertigo ◽  
Paroxysmal Positional Vertigo

scholarly journals Teleconsultation and Teletreatment Protocol to Diagnose and Manage Patients with Benign Paroxysmal Positional Vertigo (BPPV) during the COVID-19 Pandemic

2021 ◽  
Vol 25 (01) ◽  
pp. e141-e149
Author(s):  
Renato Gonzaga Barreto ◽  
Darío Andrés Yacovino ◽  
Lázaro Juliano Teixeira ◽  
Mayanna Machado Freitas
Keyword(s):  
Disease Transmission ◽  
Benign Paroxysmal Positional Vertigo ◽  
Good Clinical Practice ◽  
Relevant Information ◽  
Remote Access ◽  
Vestibular Disorder ◽  
Face To Face ◽  
Positional Vertigo ◽  
Video And Audio ◽  
Paroxysmal Positional Vertigo

Abstract Introduction Telehealth consists in the application of technology to provide remote health service. This resource is considered safe and effective and has attracted an exponential interest in the context of the COVID pandemic. Expanded to dizzy patients, it would be able to provide diagnosis and treatment, minimizing the risk of disease transmission. Benign paroxysmal positional vertigo (BPPV) is the most common vestibular disorder. The diagnosis typically rests on the description of the symptoms along with the nystagmus observed at a well-established positional testing. Objectives The aim of the present study was to propose a teleconsultation and teletreatment protocol to manage patients with BPPV during the COVID-19 pandemic. Methods Specialists in the vestibular field met through remote access technologies to discuss the best strategy to manage BPPV patients by teleconsultation and teletreatment system. Additionally, several scientific sources were consulted. Technical issues, patient safety, and clinical assessment were independently analyzed. All relevant information was considered in order to design a clinical protocol to manage BPPV patients in the pandemic context. Results Teleconsultation for BPPV patients requires a double way (video and audio) digital system. An adapted informed consent to follow good clinical practice statements must be considered. The time, trigger and target eye bedside examination (TiTRaTe) protocol has proven to be a valuable first approach. The bow and lean test is the most rational screening maneuver for patients with suspected positional vertigo, followed by most specific maneuvers to diagnostic the sub-variants of BPPV. Conclusion Although with limited evidence, teleconsultation and teletreatment are both reasonable and feasible strategies for the management of patients with BPPV in adverse situations for face-to-face consultation.

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