2024 Course. May 31st and June 4th.

​

This page provides you with the resources that you will need before the short course on vestibular disease and a timetable of activities for you to follow.

​

Session 1 - May 31st 2024.

​

Prior to this session you should have read the topics listed here and watched the YouTube videos listed. These will help you understand the basics of vestibular anatomy and physiology, some of which you may well already know.

 

In class you will have an assessment via Kahoot! and we will have a chance to discuss areas of difficulty while we do that.

​

Following the Kahoot! we will discuss the generation of vestibular nystagmus and what we look for when we examine for it. We will also discuss the control of eye movements, in particular saccades and smooth pursuit circuits, vestibulo-spinal reflexes, and testing of spino-cerebellar and dorsal column function.

​

Here are the resources for you to read and view:

​

Anatomy of the inner ear: https://www.enteducationswansea.org/copy-of-anatomy-of-the-inner-ear

Physiology of the vestibular organ: https://www.enteducationswansea.org/vestibular-physiology

 

VOR: https://www.youtube.com/watch?v=QaYoO6Ewnsg&list=PLSL-eqKP1SPEU-SZs88m3LjYCaZ_p7PBK&index=10

Brainstem connections of the vestibular apparatus: https://www.youtube.com/watch?v=cXhe20THed8

Basic intro to utricle and saccule: https://www.youtube.com/watch?v=5iZAnn5HlVw

Basic intro to semi-circular canals: https://www.youtube.com/watch?v=uCRx5pr1n2I

​

​

Session 2 - May 31st 2024

​

This session will focus on vestibular examination and will include the following activities:

​

Smooth pursuit and saccade testing

Observing for spontaneous and gaze-evoked nystagmus

Testing the vestibulo-ocular reflexes (head thrust and head shake testing)

Gait, heel-toe, and Romberg's testing

The Fukuda step test

Dix-Hallpike testing and the Epley manoeuvre

​

Post-sessional work.

​

Following the session you will be divided into 4 groups. Each group will prepare a short summary of a balance disorder for the following teaching session on June 4th 2024.

​

The diseases to be presented are shown here together with some resources to use to make your presentation:

​

Benign Paroxysmal Positional Vertigo (BPPV)

AAO-HNS Guidelines for the management of BPPV. (There is a lot of really useful information in there. Focus on the posterior canal BPPV information)

Wikipedia page. Really good wiki coverage.

​

Ménière's Disease

Classifying MD.

Wikipedia page.   

​

Vestibular neuritis and labyrinthitis

General information from VEDA.

Dizziness and Balance website.

​

Persistent postural-perceptive dizziness (PPPD)

British Medical Journal article

​

​

Session 3.

​

We will review the concept of vestibular failure and compensation, how is happens, and what we can do to enhance it. This will be via a Kahoot! and discussion.

​

Student pairs will present their work on balance diseases. 10 minutes maximum. Each presentation must include a summary of the typical findings from history taking. They must also include diagnostic tests / exams, and management.

​

​

Post-sessional work.

​

Do the vestibular cases test. Click on the link to be taken to a short test on what we have covered.

​

Read up on nystagmus, Alexander's law, the vestibulo-ocular reflex and Dix-Hallpike and Epley manoeuvres.

​

Dix-Hallpike.

Epley manoeuvre.

Nystagmus.

Head impulse testing for VOR.

​

​