Anatomy and Physiology of the Vestibular System (1.5 Credits)
This course is designed to introduce the students to the basic terminology, structure, and function of the vestibular system. Students will learn the physics of the vestibular labyrinth, the eyes and eye muscles, and how the vestibular organs interact with the visual and oculomotor systems of the brain, with the cerebellum, with the spinal cord, and with the cerebral cortex. The course will also introduce concepts of how we stabilize gaze and posture, move around in a coordinated fashion, and perceive self-motion. Vestibular disorders and clinical test procedures will be mentioned when relevant.
Pathologies of the Vestibular System (1.5 Credits)
The course will provide a brief review of the functional physiology of the vestibular system and will focus on the pathophysiology of the peripheral and central vestibular system. Various disorders will be discussed such as endolymphatic hydrops (Meniere’s syndrome), benign positional vertigo and its variants; labyrinthitis; vestibular neuritis; migraine; vascular disorders; metabolic disorders; tumors of the internal auditory canal; cerebellopontine angle and brainstem and psychological manifestations of vestibular disorders.
Each pathology will be discussed in terms of: 1) pathophysiology; 2) clinical features; 3) diagnosis and 4) management for each disorder or pathology. Vestibular disorders will be classified in terms of location (e.g. peripheral vs. central vestibular disorders) or by pathophysiology (e.g. vascular, neurologic, multisensory etc). Emphasis will be on the clinical presentation of the pathology and what findings we would expect using various diagnostic procedures. Case examples will be provided as an illustrative tool. The participant who successfully completes this course will acquire a clinical knowledge of clinical symptoms or pathologies giving rise to vestibular abnormalities.
Basic Vestibular Diagnosis: (1.5 Credits)
This course is designed to introduce the students to the core components in a basic evaluation of the vestibular system. Students will learn how to obtain a diagnostically-driven case history and apply when evaluating test results. Students will learn how to administer and interpret common bedside/office evaluations of the vestibular ocular reflex (VOR) and vestibular spinal reflexes (VSR). Students will understand theoretical considerations in ocular motility, positioning, positional, and caloric stimulation of the peripheral vestibular system. Students will learn to interpret results of VNG/ENG accurately and report on findings in a meaningful manner.
Advanced Vestibular Diagnosis(1.5 Credits)
This course will present the principles involved in advanced vestibular testing in adults with complaints of dizziness, vertigo, or imbalance. We will cover tests of angular head acceleration (rotary chair, vestibular autorotation – VAT, head impulse tests – HIT and Omniax Epley Chair evaluation of bilateral or multi-canal BPPV) and tests of head translation or standing postural control (cervical and ocular vestibular evoked myogenic potentials – cVEMPs & oVEMPs, and Computerized Dynamic Posturography – CDP). We will conclude with a review of the often overlooked interaction between psychological factors and dizziness, and review methods to detect when chronic subjective dizziness may be a co-factor in discerning the cause of obscure patient complaints. Clinical case examples will be provided as a tool to illustrate clinical practices and procedures commonly utilized in advanced vestibular testing. After successful completion of this course, the student should have acquired a working knowledge of advanced vestibular testing and a critical understanding of the informational yield each may provide.
Pediatric Vestibular Assessment and Treatment (1.5 Credits)
This course is designed to introduce the students to pediatric vestibular dysfunction and assessment. Students will learn how vestibular dysfunction presents in children as well as which diagnoses are most common. Students will learn how to obtain a thorough case history. Students will learn how to modify, administer, and interpret common bedside and diagnostic evaluations of the vestibular system. This course will discuss appropriate referrals and rehabilitation methods for children with vestibular dysfunction.
Vestibular and Balance Rehabilitation and Therapy (1.5 Credits)
The program will introduce the principals and basic techniques of Vestibular and Balance Rehabilitation Therapy (VBRT). The primary emphasis of the course will be to develop the skills necessary to assist in the development and execution of a treatment program for the dizzy patient. A review of the pathophysiology and normal compensation process of vestibular disorders will be discussed and how symptomotology and test results will influence VBRT. The course will assume prior knowledge of the anatomy and physiology of the vestibular system and a familiarity with assessment techniques in the diagnosis of vestibular disorders such as VNG, platform posturography, rotary chair, electrocochleography, VEMP, passive and active head rotation etc.
Case Studies and Clinical Problems and Solutions in Vestibular Pathology (1.5 Credits)
This course will present case studies representing five different subtypes of vestibulopathy that typify conditions encountered in adults who complaint of dizziness, vertigo, or imbalance. We will cover prototypical cases, highlighting the core clinical indicators for each condition. We will also show variations patient presentations, test results and outcomes. Finally we will highlight the difference between a syndrome and a disease, and how these distinctions help establish a prognosis.
Professional Issues in Vestibular and Balance disorders (1.5 Credits)
This course will look at the professional aspects of providing vestibular and balance evaluations and treatment. Discussion will include how balance fits into the general healthcare needs of the future. Reimbursement, evaluation models, ethical views, patient populations and possible treatment views will be presented and discussed. Case study material incorporating skills from previous courses in the series will serve to illustrate the practical outcomes at various skill levels for the professional practice.