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Related Experiment Videos

General vestibular testing.

Thomas Brandt1, Michael Strupp

  • 1Department of Neurology, Ludwig Maximilians University, Marchioninistr. 15, 81377 Munich, Germany. thomas.brandt@med.uni-muenchen.de

Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology
|January 22, 2005
PubMed
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Vestibular system dysfunction causes dizziness, nystagmus, ataxia, and nausea. Diagnosis requires interdisciplinary evaluation, including history, neuro-otological exams, and specific bedside tests like the head-impulse test.

Area of Science:

  • Neurology
  • Ophthalmology
  • Otolaryngology

Background:

  • Vestibular system dysfunction presents with perceptual, ocular motor, postural, and autonomic symptoms like vertigo, nystagmus, ataxia, and nausea.
  • These symptoms arise from various central nervous system sites and require interdisciplinary diagnostic approaches.

Purpose of the Study:

  • To outline a practical diagnostic framework for vestibular syndromes.
  • To emphasize the importance of systematic neuro-otological and neuro-ophthalmological examinations for differentiating central and peripheral disorders.

Main Methods:

  • Detailed patient history categorized into 9 distinct types of vestibular symptoms.
  • Systematic neuro-ophthalmological and neuro-otological examination, including assessment for nystagmus and ocular motor dysfunctions.

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  • Bedside testing, notably the head-impulse test for vestibulo-ocular reflex, and laboratory evaluations of eye movements, semicircular canal, otolith, and postural function.

    • Main Results:

    • A 9-category classification aids in the differential diagnosis of vestibular syndromes.
    • Identification of key clinical signs such as nystagmus, ocular tilt reaction, and peripheral vestibular deficits.
    • The head-impulse test is highlighted as a crucial bedside tool for assessing the vestibulo-ocular reflex.

    Conclusions:

    • Accurate diagnosis of vestibular disorders necessitates an integrated approach combining patient history, clinical examination, and targeted investigations.
    • Findings must be interpreted within the broader context of a complete neurological assessment.