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Vestibular Glossary    

         
Jeff Walter PT, DPT, NCS complier edited and linked by Timothy C. Hain, MD Page last modified: May 10, 2017

Acephalgic:  Without head pain, usually in the context of migraine.

Acrophobia: Fear of heights

Ageotropic nystagmus: Movement tendency directed away from the earth, usually found in lateral canal BPPV

Agoraphobia: Fear of busy, open marketplaces

Alexander’s Law:  Peripheral vestibular-origin nystagmus is enhanced with gaze directed toward the fast phase. See gaze-evoked nystagmus.

AminoglycosidesGroup of antibiotics that can produce vestibular or cochlear toxicity

Ampulla: Dilated ending of the semicircular canal containing the cupula

Ampullofugal: Refers to displacement “away” from the ampulla

Ampullopetal: Refers to displacement “toward” the ampulla

AntihistamineClass of medications utilized to address chronic vertigo or motion sickness. An example is meclizine.

Antivert (Meclizine):  Antihistamine used to promote vestibular sedation with chronic vertigo or motion sickness

Ataxia:  incoordination

Ativan (Lorazepam):  Benzodiazepine used to promote vestibular sedation with acute vertigo

AudiometryTest of hearing

Autophony: Hearing of a person's own voice, breathing or other self-generated sounds. Usually seen in eustachian tube disorders (ETD).

Barany Maneuver (aka Dix-Hallpike, Hallpike):  Testing procedure intended to identify anterior or posterior canal BPPV

BenzodiazepinesClass of medications utilized to promote vestibular sedation with acute vertigo
 
Caloric Testing:  Component of ENG/VNG testing, intended to assess for asymmetric horizontal canal / superior vestibular nerve function, that involves irrigation of warm and cold water or air into the external auditory canal

Canalithiasis: Variant of BPPV where otoconia are free floating within the semicircular canal

Canalith Repositioning ManeuversTreatments intended to move displaced otoconia from the affected semicircular canal to the utricle

Cephalgia:  Head pain

CerebellumPortion of the brain that modulates balance, limb and eye movements

Cholesteatoma:  Mass growing within a confined space, often the middle ear

Cisplatin:  Chemotherapy agent toxic to hearing

Cochlea: the auditory portion of the labyrinth

Collic:  Referring to the neck

Cupulolithiasis: Variant of BPPV where otoconia are adherent to the cupula

Dehiscence:  Refers to a split or opening in a structure, such as in superior canal dehiscence

Diazepam (Valium):  Benzodiazepine used to promote vestibular sedation

Dimenhydrinate (Dramamine):  Antihistamine used to promote vestibular sedation with chronic vertigo or motion sickness

Diplopia:  Double vision

Dix-Hallpike Maneuver (aka Barany, Hallpike):  Testing procedure intended to identify anterior or posterior canal BPPV

Dizziness:  Non-specific term encompassing feelings of imbalance, spinning and lightheadedness

Dramamine (Dimenhydrinate):  Antihistamine used to promote vestibular sedation with chronic vertigo or motion sickness

Dysarthria:  Difficulty articulating words

Disequilibrium (or Dysequilibrium): Subjective sense of unsteadiness

Electronystagmography:  Measurement of eye movements with electrodes surrounding the orbit

Emesis:  vomiting

Epley Maneuver:  Treatment for posterior canal BPPV

Ewald’s Laws

Fistula (Perilymph):  Abnormal opening between the fluid-filled inner ear and the air-filled middle ear

Fixation:  Maintenance of gaze on a single location

Fovea: Center portion of the retina, the region of highest visual acuity

Frenzel goggles:  Utilized to block gaze fixation with the use of magnified lenses and illumination

Fukuda Step Test:  Postural control test utilized to uncompensated unilateral vestibular loss

Fullness:  Perception of ear pressure

GentamicinAntibiotic with vestibular-toxic properties

Geotropic: Movement tendency directed toward the earth

Habituation:  An acquired tolerance gained by repeated exposure to a particular stimulus

Hallpike Maneuver (Barany, Dix-Hallpike):  Testing procedure intended to identify anterior or posterior canal BPPV

Hydrops:  Distention of the labyrinth with fluid, a likely component of Meniere’s Disease

HyperacusisDiscomfort induced by noises that are not painful to most people.

Imbalance: Observable unsteadiness

Labyrinth: Refers to the inner ear which includes the cochlea and vestibular organs

Latency:  The time between the initiation of a stimulus and the clinical manifestation of the disease

Lateropulsion:  Tendency to fall to the side

Lightheadedness: Feeling of faintness

Lorazepam (Ativan):  Benzodiazepine used to promote vestibular sedation with acute vertigo

Otolithic Crisis of Tumarkin: A sudden unexplained fall without loss of consciousness or vertigo, attributed to an abrupt change in otolithic input. Usually found in Meniere's disease.

Otoneurologist: Neurologist that specializes in ear conditions such as dizziness.

Maculae:  Sensory epithelium contains hair cells that are stimulated by linear acceleration and deceleration within the otolithic organs

Mastoid:  Sinus at the base of the skull behind the ear, containing air spaces that connect with the middle ear cavity 

Meclizine (Antivert):  Antihistamine used to promote vestibular sedation

Neurotologist: Otolaryngologist who specializes in inner ear disorders, especially tumors.

Neuroophthalmologist: Ophthalmologist (eye doctor) who specializes in neurological problems affecting the eyes.

Nystagmus: Involuntary jumping of eyes that resets the eyes during prolonged rotation and directs gaze towards the oncoming visual scene

Ocular flutter: Bursts of saccadic activity that involve rapid, involuntary, uni-planar, conjugate eye movements around the point of fixation without an inter-saccadic interval

Ophthalmoplegia:  Weakness of one or more of the eye muscles that control eye movment 

Optokinetic: generates eye movements in response to sustained rotations of objects that encompass a large portion of the visual field

Opsoclonus: Bursts of saccadic activity that involves rapid, involuntary, non-rhythmic, multidirectional, conjugate eye movements without significant inter-saccadic interval.

Orthogonal:  Intersecting at 90 degree angles

Orthostatic Tremor:  Rhythmical muscle contractions present with standing

Oscillopsia:  Gaze instability, usually due to bilateral vestibular reduction

Ossicles:   Middle ear bones (malleus, incus and stapes) that transmit sound from the tympanic membrane to the oval window of the inner ears.

Otalgia:  Pain in the ear

Otoconia: Calcium carbonate crystals embedded within the maculae within the otolith organs.

Otolithic Crisis of Tumarkin:  Sudden, conscious falls that occur without warning likely due to inappropriate otolith activity, usually associated with Meniere's disease.

Otolith Organs:  Refers to the utricle and saccule

Otoliths:  Otoconia

Ototoxic:  Having a harmful affect on labyrinthine structures

ParaneoplasticCaused by the presence of cancer in the body but not the physical presence of cancerous tissue in the part or organ affected

Paroxysmal:  Recurrent and sudden intensification of symptoms

Perilymph:  Fluid situated between the bony and membranous labyrinth

Phenergan (Promethazine):  Antihistamine utilized to address chronic vertigo and motion sickness

Phonophobia:  Fear/sensitivity to sound. Associated with migraine and hyperacusis

Photophobia:  Fear/sensitivity to light, usually associated with migraine.

Pitch:  To turn about a medial-lateral (y) axis. In other words, the axis between your ears. See here for more.

Promethazine (Phenergan):  Antihistamine utilized to address chronic vertigo and motion sickness

Pulsion: The feeling of being pulled in a certain direction

Roll:  To turn about an anterior-posterior (x) axis. See here for more.

Roll Test:  Maneuver intended to identify horizontal canal BPPV. Better word is "supine roll test".

Romberg Test: Bedside maneuver to detect imbalance.

Saccades:  Abrupt, rapid movement of both eyes utilized to change the point of fixation

Saccule:  Otolithic organ that primarily detects vertical and forward linear accelerations

Schwannoma:  Solid, usually benign tumor derived from Schwann cells. When involving the 8th nerve, termed an acoustic neuroma.

Semicircular canal:  Circular, fluid-filled, ducts within the vestibular organ responsible; structure promotes the detection of angular accelerations

Semont Maneuver:  Treatment for  posterior canal BPPV, canalithiasis or cupulolithiasis

Smooth pursuit: Maintains image of a small moving target on the fovea

Stapedectomy:  Surgical removal of the stapes followed by prosthetic replacement. Usually for otosclerosis.

Syncope:  Loss of consciousness

Temporal Bone:  Portion of the skull containing the labyrinth. Hardest bone in the body.

Tinnitus:  Ringing in the ears

Torsion:  Rotation around the anterior-posterior. Also known as roll.

Tropia:  Deviation in ocular alignment that persists with both eyes viewing.

Tullio’s Phenomena:  Vestibular symptoms elicited by sound. Usually associated with superior canal dehiscence.

UtricleOtolithic organ that primarily detects horizontal linear accelerations

Utriculofugal:  displacement away from the utricle

Utriculopetal:  displacement toward the utricle

Valium (Diazepam):  Benzodiazepine medication used for vestibular sedation.

Valsalva Maneuver:  Attempt to forcibly exhale with the glottis, nose and mouth closed. Used to diagnose superior canal dehiscence as well as some types of syncope.

Vestibular-Evoked Myogenic Potential (VEMP):  Laboratory test of saccular / inferior vestibular nerve function

Vergence:  Movement of the eyes in opposite directions, usually induced by taking up near or far vision

Vertigo:  Dizziness characterized by a sense of spinning

Vestibular:  Refers to the vestibular (balance) portion of the labyrinthine organ

Vestibulopathy:  Disease to the vestibular organ

Visual fixation:  Holds the image of a stationary object on the fovea by minimizing ocular drifts

Videonystagmography:  Measurement of eye movements with the use of video

Yaw:  To turn about a vertical (z) axis

Abbreviations

ABC:  Activities specific Balance Confidence scale. One of numerous questionnaires used to quantify balance.

BOS:  Base Of Support

BPPVBenign Paroxysmal Positional Vertigo. A common inner ear type of vertigo due to loose crystals.

BVL:  Bilateral Vestibular Loss

CDP:  Computerized Dynamic Posturography

COG:  Center of Gravity

COR:  Cervical-Ocular Reflex

CRT, CRM, CRP:  Canalith Repositioning Treatment. Several acronyms all being the same set of ethods of treating BPPV.

CTSIB:  Clinical Test of Sensory Interaction for Balance. A bedside method of assessing balance. Also known as "foam and dome". Similar to the Romberg test.

DBN:  Downbeat Nystagmus. Eyes jump downward. There us also UBN (upward). While there should be a TBN (eyes twist, nobody has invented this acronym as yet).

DGI:  Dynamic Gait Index. One of many methods of assessing balance. More lengthy but similar to the Romberg test.

DHI:  Dizziness Handicap Inventory, one of numerous questionnaires used to quantify balance.

DVA:  Dynamic Visual Acuity.

ENG:  ElectroNystagmoGraphy, also known as VNG and VENG.

GEN:  Gaze-evoked nystagmus

HSN:  Head-Shaking induced Nystagmus

IHS:  International Headache Society. Society that develops lists of symptoms used to group headaches.

INO:  InterNuclear Ophthalmoplegia. Pattern of slowed medial going eye movements often found in multiple sclerosis

LVN:  Lateral Vestibular Nucleus

MDD:  Mal De Debarquement. Prolonged dizziness after getting off boat.

MLF:  Medial Longitudinal Fasciculus. Structure damaged in INO

MRD:  Migraine Related Dizziness. Also known as MAV (migraine associated vertigo), Vestibular migraine, and others.

MS:  Multiple Sclerosis

MSQ:  Motion Sensitivity Quotient. Output of a questionnaire designed to measure motion sickness.

MVN:  Medial Vestibular Nucleus. A small piece of the vestibular nucleus complex in the brainstem.

OKN:  OptoKinetic Nystagmus

PAN:  Periodic Alternating Nystagmus

PICA:  Posterior Inferior Cerebellar Artery. Artery that supplies the vestibular nucleus.

POT:  Primary Orthostatic Tremor -- a rare cause of unsteadiness on standing -- (not to be confused with POTS -- positional orthostatic tachycardia syndrome).

PPRF:  Paramedian Pontine Reticular Formation. Brainstem structure that drives rapid eye movements to the sides.

SCC:  SemiCircular Canal

SCD:  Superior Canal Dehiscence

SNHL:  SensoriNeural Hearing Loss

SLS:  Single Limb Stance -- a variant of the Romberg test.

SOT:  Sensory Organization Test

SVA:  Static Visual Acuity (as opposed to dynamic visual acuity). SVA is how well you see with your head still.

SWJ:  Square Wave Jerks

TUG:  Timed Up and Go -- one of many methods of quantifying balance.

UVL:  Unilateral Vestibular Loss

VBI:  Vertebral-Basilar Insufficiency

VCR:  Vestibulo-Collic Reflex

VEMPs:  Vestibular Evoked Myogenic Potentials

VNG:  VideoNystagmoGraphy (newer name for ENG). Also known as VENG.

VOR:  Vestibular-Ocular Reflex

VRT:  Vestibular Rehabilitation Therapy

VSR:  Vestibulo-Spinal Reflex

Copyright May 10, 2017 , Timothy C. Hain, M.D. All rights reserved. Last saved on May 10, 2017