SPA 6317
VESTIBULAR DISORDERS
Spring 2007
Sect # 8050
Course Meets: Th 1:00 – 3:00 Instructor: Scott K. Griffiths, Ph.D.
In HPNP 2131 Office: 339 Dauer Hall Office Hrs: MW F 8:00 - 9:30 & by appt.
e-mail:
tel. 392-2113 ext 248
GOAL OF THIS COURSE: Students in this course will gain an understanding of how humans maintain balance, the contribution of the inner ear to balance, disorders of balance, and approaches to rehabilitation of these disorders.
Behavioral Objectives. Students completing this course will be able to:
1) Identify and describe all of the sensory systems involved in balance
2) Identify 6 items from a case history interview that are important to the management of a balance complaint.
3) Complete and describe significance of the results from the following tests:
a. Ocular motility
b. Stepping Fukuda
c. Halmagyi Head thrust
d. Modified CTSIB
e. Romberg
f. Dix-Hallpike maneuver
4) Identify the strengths and weaknesses of each of the following assessment procedures:
a. Oculomotor testing using ENG/VNG
b. Positional testing using ENG/VNG
c. Caloric Testing using ENG/VNG
d. Rotational testing
e. Posturographic testing
5) Correlate case history and diagnostic results and name appropriate management steps for several
common disorders producing balance complaints.
Readings:
Primary Text: Desmond, A.L. Vestibular Function: Evaluation and Treatment. 2004. New York: Thieme. ISBN 1-588890-166-1
Other Readings will be assigned out of the following texts made available to the class:
JNK = Jacobson, G.P., Newman, C.W. & Kartush, J.M. Handbook of Balance Function Testing
Chs 3, 5,6,7,8 & 9
S&T = Shepard, N.T. Telian, S.A. Practical Management of the Balance Disorder Patient
Ch 6
G = Goebel, J.A. Practical Management of the Dizzy Patient
Chs 16 & 17
SCHEDULE OF TOPICS: READINGS:
Intro/Basic Anatomy & Physiology Chs 1&2
JNK Ch3 (Carl: Practical A&P-Ocular Motor Sys)
Case History & Physical Exam Ch 3
Evaluation Chs 3-4
ENG
Ocular-Motor JNK chs 5-6 (Hain: Ocular Motility Testing)
Positional Testing JNK chs 7 (Brandt: Positional/Positioning)
Caloric Testing JNK chs 8-9 (Jacobson et al: Caloric Testing)
Rotational Testing S&T Ch 6 (Rotational Chair Testing)
Posturography
Imaging and Serology G Chs 16-17 (Wippold: Imaging; Hughes: Serology)
Treatment Protocols Ch. 6
Balance Clinic Operations Chs 7-8
Lab Activities: The class will have the opportunity to visit the Hampton Oaks balance clinic and practice assessment techniques. Practice will also be available in Dauer Hall. Announcements of available dates and sign up sheets for these will be forthcoming. Activities will include screening tests, the VNG battery, and posturographic testing.
Class Notebook: Students will be required to maintain and submit a class notebook (which may be submitted electronically) in which they provide organized summaries of their readings, class and lab experiences, and any outside experiences they deem relevant. The major sections of this notebook will be:
1) Readings & Lectures
a. Key information you learned
b. Additional questions you generated
c. How you got these questions answered
d. Your opinions on what you learned and how
2) Lab experiences
a. Specific procedures or protocols you learned
b. Description and (where possible) copies of results you obtained.
c. Additional questions you generated
d. How you got these questions answered
e. Your opinions of the experience
3) Balance Disorders topics (10)
a. Presenting history and symptoms
b. Underlying etiology
c. Diagnostic steps
d. Management options and prognosis
4) Other experiences
a. Description of you experience
b. Key knowledge or skills you acquired
c. Reflect on the effect this experience had on you.
Grading: Students will be graded on the class notebook and two exams in this course. Course grades (A95,B+88, B82,C75,D65, E<65) will reflect the following weighting:
Item: Date: Weighting:
Exam 1 Feb 15th 30pts
Exam2 April 12th 30 pts
Class Notebook April 30th 40 pts
Academic Honesty Policy
Academic dishonesty in any form will not be tolerated. Students suspected of violating the University’s policies on academic honesty will be dealt with in accordance with procedures outlined by the Office of Student Judicial Affairs. If you have not done so already, please familiarize yourself with the University's policy on academic dishonesty.
Cheating. The improper taking or tendering of any information or material, which shall be used to determine academic credit. Taking of information includes, but is not limited to, copying graded homework assignments from another student; working together with another individual(s) on a take-home test or homework when not specifically permitted by the teacher; looking or attempting to look at another student's paper during an examination; looking or attempting to look at text or notes during an examination when not permitted. Tendering of information includes, but is not limited to, giving your work to another student to be used or copied; giving someone answers to exam questions either when the exam is being given or after taking an exam; giving or selling a term paper or other written materials to another student; sharing information on a graded assignment.
Plagiarism. The attempt to represent the work of another as the product of one's own thought, whether the other's work is published or unpublished, or simply the work of a fellow student. Plagiarism includes, but is not limited to, quoting oral or written materials without citation on an exam, term paper, homework, or other written materials or oral presentations for an academic requirement; submitting a paper which was purchased from a term paper service as your own work; submitting anyone else's paper as your own work.
Bribery. The offering, giving, receiving, or soliciting any materials, items or services of value to gain academic advantage for yourself or another.
Misrepresentation. Any act or omission with intent to deceive a teacher for academic advantage. Misrepresentation includes using computer programs generated by another and handing it in as your own work unless expressly allowed by the teacher; lying to a teacher to increase your grade; lying or misrepresenting facts when confronted with an allegation of academic honesty.
Conspiracy. The planning or acting with one or more persons to commit any form of academic dishonesty.
Fabrication. The use of invented or fabricated information, or the falsification of research or other findings with the intent to deceive for academic or professional advantage.
Special Needs and Counseling Services
The University of Florida, under the guidelines of ADA and 504 federal legislation, is required to make reasonable accommodations to the known physical and mental limitations of otherwise qualified individuals with disabilities.
To help provide the best possible service to students, staff, faculty and visitors, the University of Florida has an Americans with Disabilities Act Office with a coordinator responsible for access for persons with disabilities. The ADA coordinator assists anyone with questions about access.
See http://www.ada.ufl.edu/office/ada.htm for more information
Other resources:
q Campus Alcohol and Drug Resource Center (302 Student Health Center, 392-1161, ext. 4281).
q University Counseling Center (301 Peabody Hall, 392-1575)
q Student Mental Health Services (245 Student Health Center, 392-1171).
BALANCE DISORDERS TOPICS:
Autoimmune Inner Ear Disease
Canalithiasis/Cupulolithiasis
Cerebellar infarction
Vestibular Ototoxicity
Allergic Balance difficulties
Glomus Jugulare
Parkinsonism
Orthostatic Hypotension
Vestibular Neuritis
Positional Alcohol Nystagmus
Ocular Tilt Reaction
Acrophobia/Agoraphobia
Benign Paroxysmal Torticollis – Infancy
Vertebro-basilar Insufficiency
Viral encephalitis
INO& Multiple Sclerosis
Balance Disorders related to polyneuropathy
Crisis of Tumarkin
Vestibular Atelectasis
Migraine
Mal de Debarquement
Arnold Chiari Syndrome
Vestibular Schwannoma
Baro-/Surgical trauma & Perilymph Fistula
Vertiginous Epilepsy
Cervical Vertigo
Motion Sickness
Vestibular Labyrinthitis
TIA and Stroke-related balance disorders
Waldenström’s Disease
Familial Periodic Ataxia/Vertigo
Space Adaptation Phenomenon
Head-extension Vertigo
Positional Glycerol nystagmus
Wallenberg’s Syndrome
Vestibular Aging
Paget’s Disease
Diabetes