Vestibular Issues And Balance Disorders CEU Courses

This talk aims to unravel the fundamentals of vestibular assessments in children. It is specifically designed for clinicians taking their first steps in incorporating pediatric vestibular assessments into their practice.

Given their training in the detection and non-medical management of both hearing and balance disorders, most audiologists believe that falls risk management is within their professional scope of practice. However few hearing professionals incorporate fall risk screening into their practice or feel sufficiently trained to do so. This course will discuss how attendees can work within their scope of practice to implement fall prevention and management to help reduce the burden of their patients' underlying risk factors of falling.

Vestibular rehabilitation therapy (VRT) is scarcely offered by audiologists but can be a powerful tool when implemented. This course aims to share the principles and format of a VRT program and educate the clinician in establishing multidisciplinary healthcare teams to best serve the dizzy patient.

Vestibular disorders in children are a significant cause of childhood morbidity with various manifestations that are often unrecognized or undiagnosed. The etiological profile, phenotype, and management for peripheral and central disorders are markedly different from that in adults. The diagnostic algorithm with the latest technology is also different as children are far more difficult to obtain anamnesis from and to test as compared to adults. Examining a child is really an art that can come from years of experience and knowledge about the pediatric vestibular system and its development. It is also important to recognize the close overlap with pediatric neurology and indeed, a robust knowledge in neurology is essential to practice pediatric neurotology. This presentation includes an overview of the developing pediatric vestibular system in children, the etiology of pediatric vestibular disorders, the diagnostic process with evidence-based latest methods, and their management. The differences in pediatric vestibular diagnosis and disease profiles are also highlighted from the authors’ personal series.

The introduction of modern tools assessing otolith and ampullary reflexes in the high-frequency domain (VEMPs and video-HIT, respectively) has enabled a fast functional analysis of all inner ear receptors, offering new interpretations for end-organs and afferents abnormalities detected in patients with cochleo-vestibular pathologies. The literature review highlights how vestibular disorders could result in specific lesion patterns, including selective dysfunctions involving a single receptor. A series of patients with isolated impairment of a semicircular canal at the video-HIT will be presented and discussed. Each selective canal dysfunction will be correlated to the remaining clinical-instrumental data and related inner ear pathology. The underlying hypothetical pathomechanism accounting for each single scenario will be provided, with the help of pertinent bibliographic support.

Visually Induced Dizziness is often described by patients attending the balance clinic. It is associated with peripheral and central vestibular disorders, can be one of the more disabling aspects of the patient’s condition and, if not identified and managed effectively, will impact a patient’s recovery. During this session, the speaker provides tools and resources to identify Visually Induced Dizziness, context to help explain the condition to patients, and tips and tricks on how to manage patients with this disease.

Selecting vestibular assessment tests should be based on medical necessity and answering clinically based questions related to individual patient symptoms, past medical history, and signs. This intermediate presentation will provide an overview of vestibular measures and best-practice guidelines in vestibular assessment, and help the attendee understand best-practice approaches in the vestibular clinic.

Within the past 5 years there has been a rebirth of interest in an evoked potential referred to in the past as the “inion potential.” In this session we will describe its history, recordability and potential usefulness in the assessment of the vestibular cerebellum.

Dizziness is one of the most common symptoms after concussion, and audiologists are sometimes the first group to perform testing. This course will teach audiologists which tests may be performed, as well as the results, after concussion to determine vestibular system impairments.

Sheila Thelen, President of Vestibular Training Services and Master Rated Figure Skating Coach, applied these world-class vestibular training tools (USA Patent) in an INNOVATION presentation on how spinning affects the vestibular system and can improve the brain’s ability to balance and the cognitive processes. Sheila speaks about applying world-class athletic training tools to the general population.