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A comprehensive treatment of brain injuries and concussion, which did not result in loss of consciousness, what we call Subtle© Brain Injury. A large portion of those with Subtle Brain Injuries, have suffered some injury to the vestibular system. tbilaw.com A general treatment of all types of brain injury, including severe brain injury and concussion, with a special focus on the legal aspects of recovering full and adequate compensation for such injuries. tbilaw.com has been at the cornerstone of the web advocacy of the Brain Injury Law Group since it went online in 1996.

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Concussion InformationPost Traumatic Dizziness and VertigoThe Eng TestWhy ENG Testing?BPV InfoVestibular Glossary

Glossary

Attorney Gordon S. Johnson, Jr.

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For a listing of the numerous disease and associated health conditions that can cause dysfunction of the vestibular system, go to:

Vestibular Resources

Vertigo - a hallucination of movement, which is highly suggestive of
vestibular dysfunction.
Dizziness - is a non-specific term implying a sense of disorientation.
Benign Positional Vertigo
(BPV)- also called Benign Paroxysmal Positional Vertigo describes a vertigo which is often induced while a patient turns over in bed, or gets in and out of bed. It is a benign disorder, which while it will remit spontaneously, often reappears. It is diagnosed by the use of the Dix Halpike Maneuver. BPV is often cured, just after it is diagnosed, by a maneuver performed by the treating doctor, which dislodges a clot of material from one of the inner ear canals.
Cochlea - the organ in the inner ear, devoted to hearing.
Dix Halpike Maneuver - is used for the diagnosis of Benign Positional Vertigo. It involves rapidly moving the patient from a sitting position, to the head hanging position, below horizontal, such as with a head hanging off of the end of an examining table. If nystagmus is detected with this maneuver, it will indicate a diagnosis of PBV.
ENG
- Electronystagmography is a complex test, used to identify pathology with respect to the vestibular system, the cranial nerves and the brain stem. This testing involves a battery of eye movement tests, some of which require recording of nystagmus. The ENG commonly includes testing for caloric and positional testing.
Epley Maneuver - A maneuver involving a change in position of the head, used to dislodge or relocate calcium debris, causing Benign Positional Vertigo.
Inner Ear
- the part of the ear, filled with fluid, which contains the canals which are the primary sensors for changes in the position of the head.
Labyrinth - is the cavity inside the skull, containing both the organ for hearing, the cochlea, and the vestibular system.
Labyrinthitis - is a bacterially or virally caused inflammation of the inner ear . It can cause vertigo and dizziness.
Meniere's Disease - Also called "hydrops". The symptom of vertigo is accompanied by noises in the ear, pressure in the ear, or hearing changes. The cause of Meniere's is likely related to bleeding into the inner ear. The likelihood of a relationship between this diagnosis and trauma is directly correlated to the severity of the brain injury.
Middle Ear - that portion of the ear, inside the skull, which is filled with air, and is separated from the inner ear by small, thin membranes.
Neuritis - A virally caused inflammation of the vestibular nerve, the 8th Cranial Nerve.
Nystagmus - A rhythmic, repetitive, oscillatory eye movement. It may occur as a result of vestibular problems, as a result of visual problems, or as a result of certain brain stem or cerebellar abnormalities. Vestibular Nystagmus is characterized by a slow migration of the eyes in the wrong direction, followed by a sudden jerking back response.
Perilymph Fistula ("PLF") - An improper opening between the middle ear and the inner ear. The middle ear is filled with air, the inner air with fluid. When there is a defect in the membranes which separate the middle and inner ear, the changes in air pressure in the middle ear will directly impact the inner ear, disturbing the balance and hearing centers, resulting in vertigo, associated symptoms and hearing problems. It is often caused by a direct blow to the ear, or by rapid and substantial changes in either atmospheric pressure or intracranial pressure, resulting from barotrauma
Posturagraphy/Posture Platform Test - A test of vestibular function while an individual is placed on a moving platform. It is best as a serially administered test, to test whether balance is improving. Its weakness as a diagnostic tool is that it only tells the practitioner information as to what is happening at the moment of the test, so may have false negatives. It is a good cross measure of the ENG test for forensic purposes, as it is capable of detecting malingering. We are always pleased to have our clients given this test, as when the data is consistent with the ENG, it provides a valuable corroborative source, that the client is not feigning these symptoms. The outputs from these tests are quite visually interesting, also a forensic advantage.
Rotary Chair Test - Rotational Testing is a testing of the inner ear, by the mechanism of monitoring its functions, while an individual is placed in a rotating chair. It is a generally an adjunct to ENG testing, and can rule out certain blocked canal causes, of bilateral problems with the inner ear.
Top Shelf Vertigo - The experience of vertigo when reaching for something on a high shelf. Almost always related to Benign Positional Vertigo.
Vestibular Ocular Reflex - VOR The reflexive compensatory counter movement of the eyes, in response to the movement of the head, which enables the eyes to maintain focus while the head is moving.

 

Simple Glossary of Vestibular Terms

 

 

 

 

 
Sensory Brain