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Vestibular Disorders Questionaire
Complex Care Counselling
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Vestibular Disorders Questionaire
Vestibular Disorder Questionnaire
You are?
Your Name
Your Post Code
Date of Birth
GP Practice Name
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Your Vestibular
Year Vestibular Started
Approx
How?
Medicines
Infections
Inner ear problem
Calcium Debris
Brain Injury
Head Trauma
Other
Other
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My Vestibular Disorder Type
What Type (classification) of Vestibular Disorder do you have?
Benign Positional Vertigo
Labyrinthine Infarction
Vestibular Neuronitis
Labyrinthitis
Meniere’s Disease
Migraine
Mal de Debarquement
Other
Other
Benign Positional Vertigo
Benign positional vertigo, believed to be the most common type of peripheral vertigo, can be seen following head injury, vestibular neuronitis, stapes surgery, Meniere’s disease, or can present alone. The disorder is thought to be related to an abnormality in the association of the otoconia to the cupula within the membranous labyrinth, resulting in abnormal responses to endolymph movement with head motion. Symptoms are typically associated with head movement, such as rolling over or getting in or out of bed. The associated vertigo is brief, lasting only seconds in duration, and can be seen as an acute form only or in an intermittent or chronic form.
Labyrinthine Infarction
Labyrinthine infarction leads to a sudden profound loss in auditory and vestibular function, and typically occurs in older patients. This phenomenon can be seen in younger patients with atherosclerotic vascular disease or hypercoagulation disorders. Episodic vertigo may herald a complete occlusion in the form of a type of transient ischemic attack. After complete occlusion, the acute vertigo that ensues will subside, often leaving the patient with some residual unsteadiness and dysequilibrium over the next several months while vestibular compensation occurs.
Vestibular Neuronitis
Vestibular neuronitis presents as a sudden episode of vertigo without hearing loss in an otherwise healthy person. The disorder can occur as a single attack or can present as multiple attacks. It occurs more often in spring and early summer, and as a result is often associated with an upper respiratory tract infection developing around the same time. The onset of vertigo is sudden and is typically associated with nausea and vomiting, and can last for a period of days with gradual improvement over the following weeks. The disorder is often followed by episodes of benign positional vertigo.
Labyrinthitis
Labyrinthitis is an inflammatory process occurring within the membranous labyrinth that may have a bacterial or viral etiology. Viral infections produce symptoms of dizziness similar to vestibular neuronitis, except that there is cochlear dysfunction as well. Congenital measles, rubella, and cytomegalovirus infections frequently cause no vestibular symptoms. Bacterial labyrinthitis can present in a supparative form with direct involvement of the membranous labyrinth by the pathogen, or in a serous form. The serous form often is seen with acute otitis media when diffusion of bacterial toxins across the round window membrane occurs.
Meniere’s Disease
Meniere’s disease is an inner ear disorder characterized by episodic vertigo attacks, sensorineural hearing loss, tinnitus, and pressure or fullness in the involved ear. Initially, the hearing loss involves the lower frequencies and fluctuates, usually worsening with repeated attacks. The attacks are characterised by true vertigo, usually with nausea and vomiting lasting hours in duration. Histopathologically, this disorder is believed to be due to dilation of the endolymphatic spaces (hydrops) with ruptures and subsequent healing of the membranous labyrinth. Variants of the disease do occur, including vertigo without associated auditory symptoms.
Migraine
The vast majority of migraine variants are made up of the first two categories, migraine without aura, and migraine with aura. The term aura can be defined as a focal neurological disorder. Auras generally are considered to be abnormal sensory perceptions. Visual auras are the most frequent type, and may come in a wide variety of phenomena or hallucinations. It is valuable for healthcare professionals to have at least a basic understanding of migraine and audiovestibular symptoms. Vertigo, tinnitus, photophobia, and phonophobia, and occasionally hearing loss may present in at least 30% of migraine patients. Although hearing loss in migraine patients is less common than in vertigo, tinnitus, photophobia, and phonophobia, it may present as a low frequency fluctuating sensorineural hearing loss. It is possible, however, to have a permanent hearing loss or vestibulopathy (as indicated by caloric weakness) secondary to a migraine attack. The commonality of these symptoms, often make it difficult to distinguish the disorders on clinical grounds alone. This collection of symptoms may first be thought as consistent with Meniere’s disease, or other types of inner ear involvement, such as a recurrent vestibular neuronitis, particularly in patients with recurring episodes or attacks. The differential diagnosis of migraine and Meniere’s disease, then, may often present as a diagnostic enigma. In addition, 60% will report a lifelong history of motion sensitivity. Interestingly, the incidence of Meniere’s disease is twice as prevalent in migraineurs, as in the general population. The diagnostic challenge is further complicated if a differential diagnosis of multiple sclerosis (MS) is included. The initial onset of acute, debilitating vertigo will appear as the initial symptom in 5% of MS patients. As many as 50% of MS patients will experience at least one occurrence of acute vertigo at some time during the course of the disease. This may also be compounded by the fact that one in ten MS patients may present with hearing loss, which may be partial or complete, but often recovers, similar to the migraine or Meniere’s patient.
Mal de Debarquement
Mal de Debarquement, or disembarkment sickness, is actually a common and normal occurence1. It can best be defined as the continued sensation of motion, rocking, or swaying that persists after return to a stable environment following a prolonged exposure to motion, as one would encounter on a cruise, car, bus or train ride. It can be related to any form of conveyance. Most individuals who have enjoyed even a few hours on a fishing boat may have experienced this sensation of still being on the water, after they have returned to shore. This sensation may only last hours or even for a few days. It seems to be most noticeable when standing in the shower shampooing with eyes closed, lying in bed, or perhaps leaning against a stable fixture, as when one is at the sink washing the dishes. The Mal de Debarquement sensation that commonly occurs is independent of any seasickness or motion sickness that may be experienced during the cruise or travel. The individual may not have any ill feelings at all, and only notices the rocking sensation once on solid ground. A survey by Gordon, Sphitzer, and Donavitch, found that of 116 crewmembers of the Israeli naval force, 72% reported this common sensation with 67% reporting a very strong sensation following their initial voyage.
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Next
Your Vestibular
How Did Your Vestibular Start?
Sudden
Gradual
Overnight
Other
Other
Occurrence
Constant
Variable
Overnight
Other
Other
Lasts
Seconds
Minites
Hours
Days
Other
Other
Warning Signs
No
Yes
Other
Other
What are the warning signs?
Between Events
No Symptoms
Yes
Other
Other
When Symptoms
Can Walk
Cannot Walk
Need Support
Other
Other
Who Diognosed?
GP
Specialist Doctor
Neurologist
Cardiologist
Other
Other
Who Originally Diagnosed you with Vestibular Disorders?
When (Year)
Approx
Section Buttons
Vestibular Rehabilitation Therapy
Have tried VRT
No
Yes
Other
Other
When?
Type
HABITUATION EXERCISE
GAZE STABILISATION
BALANCE TRAINING EXERCISES
Other
Other
HABITUATION EXERCISE
Habituation exercise is used to treat symptoms of dizziness that is produced because of self-motion3 and/or produced because of visual stimuli. 5, 6 Habituation exercise is indicated for patients who report increased dizziness when they move around, especially when they make quick head movements, or when they change positions like when they bend over or look up to reach above their heads. Also, habituation exercise is appropriate for patients who report increased dizziness in visually stimulating environments, like shopping malls and grocery stores, when watching action movies or T.V., and/or when walking over patterned carpets and shiny floors. The goal of habituation exercise is to reduce the dizziness through repeated exposure to specific movements or visual stimuli that provokes patients’ dizziness. These exercises are designed to mildly, or at the most, moderately provoke the patients’ symptoms of dizziness. Over time, with good compliance and perseverance, the dizziness intensity can reduce due to the brain learning to ignore the abnormal signal.
GAZE STABILISATION
Gaze Stabilization exercises are used to improve control of eye movements so vision can be clear during head movement. These exercises are appropriate for patients who report problems seeing clearly because their visual world appears to bounce or jump around, such as when reading or when trying to identify objects in the environment, especially when moving about. There are two types of eye and head exercises used to promote gaze stability. The choice of which exercise(s) to use depends on the type of vestibular disorder and extent of the disorder.
BALANCE TRAINING EXERCISES
Balance Training exercises are used to improve steadiness so that daily activities for self-care, work, and leisure can be performed successfully. Exercises used to improve balance should be designed to address each patient’s specific underlying balance problem(s). 7 Also, to promote changes in balance, the exercises need to be moderately challenging, but safe enough so patients do not fall while doing them. Additionally, balance exercises should be designed to reduce environmental barriers and fall risk. For example, the exercises should help improve patients’ ability to walk outside on uneven ground or walk in the dark. For patients with Benign Paroxysmal Positional Vertigo (BPPV), the exercise methods described above are not appropriate to resolve this type of vestibular disorder. Through assessment, the type of BPPV is identified, and depending on the type, different repositioning maneuvers can be performed to help resolve the spinning that occurs due to position changes
Brief Details
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Symptoms Severity (press to deselect)
Visual Changes
None
Mild
Moderate
Severe
Frequency – 7 Days – VC
Few Days
Most Days
Almost Every Day
Other
Other
Double Vision
None
Mild
Moderate
Severe
Frequency – 7 Days – DV
Few Days
Most Days
Almost Every Day
Other
Other
Noise in Ears
None
Mild
Moderate
Severe
Other
Other
Frequency – 7 Days – NIE
Few Days
Most Days
Almost Every Day
Other
Other
Hearing Loss
None
Mild
Moderate
Severe
Other
Other
Frequency – 7 Days – HL
Few Days
Most Days
Almost Every Day
Other
Other
Fullness, Pressure, or Pain in Ears
None
Mild
Moderate
Severe
Other
Other
Frequency – 7 Days – F/P/P/E
Few Days
Most Days
Almost Every Day
Other
Other
Falling
None
Mild
Moderate
Severe
Other
Other
Frequency – 7 Days – Falling
Few Days
Most Days
Almost Every Day
Other
Other
Lightheadedness
None
Mild
Moderate
Severe
Other
Other
Frequency – 7 Days – LH
Few Days
Most Days
Almost Every Day
Other
Other
Fainting
None
Mild
Moderate
Severe
Other
Other
Frequency – 7 Days – Faint
Few Days
Most Days
Almost Every Day
Other
Other
Spinning
None
Mild
Moderate
Severe
Other
Other
Frequency – 7 Days – Spin
Few Days
Most Days
Almost Every Day
Other
Other
Unsteadiness
None
Mild
Moderate
Severe
Other
Other
Frequency – 7 Days – USteady
Few Days
Most Days
Almost Every Day
Other
Other
Brain fog
None
Mild
Moderate
Severe
Other
Other
Frequency – 7 Days – BF
Few Days
Most Days
Almost Every Day
Other
Other
Rocking/tilting
None
Mild
Moderate
Severe
Other
Other
Frequency – 7 Days – RT
Few Days
Most Days
Almost Every Day
Other
Other
Headache
None
Mild
Moderate
Severe
Other
Other
Frequency – 7 Days – Head
Few Days
Most Days
Almost Every Day
Other
Other
Fainting
None
Mild
Moderate
Severe
Other
Other
Frequency – 7 Days – Faint
Few Days
Most Days
Almost Every Day
Other
Other
Dizzyness
None
Mild
Moderate
Severe
Other
Other
Frequency – 7 Days – Diz
Few Days
Most Days
Almost Every Day
Other
Other
Fatigue
None
Mild
Moderate
Severe
Other
Other
Frequency – 7 Days – Fat
Few Days
Most Days
Almost Every Day
Other
Other
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