The vestibular system is a silent inner reference system and patients are not aware of its function unless there is something wrong. Patients can present with symptoms but only minimal signs.
One vestibular job is to foveate so we can use our 3D colour vision system. This reflex pathway includes the MLF, the most highly myelinated pathway in the brainstem. Patients often complain that their “eyes have to catch up”. Normal ambulation requires image stabilization. The otoliths likely assist in this task, which may appear simple but is actually very complex and poorly understood.
One otolithic (utricular) assessment is called subjective visual vertical. This assesses ocular counter roll, a process we will discuss.
The vestibular system may also be involved with the so-called “fight or flight” response,e and we will detail these self-protective reflexes.
There are many different labels often given to vestibular patients, including “VVM”, “MAV”, “PPPD”, “SMD”, and “vestibular concussion”. We discuss what we do and do not understand about these terms.
Patients sometimes complain of poor memory and fatigue. These complaints are also the result of vestibular deficits and we will be discussing how this occurs and why.
The understanding of vestibular pathology dictates that patients will always “recover” or “compensate”, but this is not always the case. Why is that? Test results can be entirely normal. We discuss some of the latest literature showing that these unfortunate patients are rarely psychiatric or malingering but usually have the genuine vestibular disease, which is important for the clinician to understand.
This Session Pertains to
Adult (18-64)
Access to SAC webinars and webcasts is an exclusive benefit of SAC membership.