APPROPRIATE ORIENTATION AND POSITION OF THE BODY IN SPACE DEPENDS UPON AFFERENT IMULSES FROM * The retinae. * The labyrinthes. * The proprioceptors of neck joints & muscles. * The proprioceptors of lower limbs & trunk.
AFFERENT IMULSES DERIVED FROM THESE SENSE ORGANS ARE INTEGRATED BY :- The cerebellum. The vestibular nuclei. The medial longitudinal bundle. The red nuclei. Higher centers (temporal & parietal lobes).
DISORDERED ORIENTATION IN SPACE RESULT FROM DISORDERED FUNCTION OF :- Sensory end organs. Afferent paths. Central connections.
CENTRAL CAUSES - Non affected peripheral cochlear apparatus. - Less sever but persistent vertigo. - Signs of involvement of neighboring structures. * BRAIN STEM LESIONS. * CEREBELLAR LESIONS. * CORTICAL DISTURBANCES.
BRAIN STEM LESIONS Vascular lesions. Neoplastic lesions. Encephalitis. M.S.
TAKING THE HISTORY - Onset course & duration of symptoms. - Factors that precipitate, aggravate, or relieve symptoms. -Is consciousness lost ? -Are cochlear & vestibular symptoms associated ? -Has there been recent head trauma ? -Is there numbness in hands & feet, visual impairment, or history of diabetes or anemia ? -Are there cardiac symptoms ? -Are there psychiatric symptoms ?
CLINICAL EXAMINATION Examination of the ears: - External auditory meatus. - Ear drum - Hearing. - Etc. Neurological examination: - Nystagmus. - Cranial nerves. - Co-ordination. - Motor system. - Sensory system. - Other systems.
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