Assessment and Management of Vestibular Disorders | AUDI6008

Module overview

This module is primarily intended for those taking one of our audiology programmes or taking the module stand-alone as part of career development. It might also be of interest to a student on a non-audiology degree interested in the human responses to vibration or disorders of the human vestibular system, with additional preparatory work (provided).

The module provides academic preparation for clinical work in the assessment and management of vestibular disorders. The module will include a contextual understanding of the anatomy and physiology of balance system, vestibular pathologies and their psychosocial consequences, and various forms of clinical assessment and treatment techniques. More generally, the module will enable you to develop your clinical reasoning skills, your understanding of the evidence-base underpinning clinical practice and how that evidence applies to clinical practice.

Aims and Objectives

Learning Outcomes

Having successfully completed this module you will be able to:

Demonstrate mastery of effective self-directed learning and scientific communication
Critically evaluate information, including from the research literature, on the epidemiology, differential diagnosis, assessment, treatment and psychosocial impacts of vestibular disorders
Explain the normal anatomy and physiology of the peripheral vestibular system, its associated motor functions (with emphasis on the vestibular ocular reflexes) and its interactions with other components of the balance system
Explain the pathophysiological processes, differential diagnosis and psychosocial impacts in the context of the ICF involved with acute and chronic unilateral peripheral hypofunction (from various causes and including mechanisms of recovery), BPPV (with emphasis on posterior canalithiasis), Meniere's disease, vestibular migraine and fistula/dehiscence.
Explain the principles underpinning the main vestibular assessment and treatment methods, their clinical application and the desirable features of clinical studies providing evidence of their effectiveness

Syllabus

Topics covered include:

> Anatomy and physiology

The vestibular, balance and associated visual systems
The vestibular ocular reflex and nystagmus

> Vestibular disorders

Unilateral hypofunction: causes, effects and mechanisms of recovery
BPPV: pathophysiology, testing and treatment
Meniere's disease
Vestibular migraine
Fistula and dehiscence
Various other causes of dizziness

> Assessment and differential diagnosis

Observation and interview
Bedside testing including of the vestibular ocular and spinal reflexes
Measurement of eye movements (VNG and ENG) and ocular motor testing
Semi-circular canal tests (head impulse testing, vHIT and calorics)
VEMPs
Sensory integration and posture

> Impact and management

Impact of vestibular disorders on life
Outcome measures
Vestibular rehabilitation

> Critically appraising evidence

Systematic reviews
Treatment: RCTs and measures of effectiveness (including ARR and NNT)
Testing: cohort studies and measures of effectiveness (including sensitivity, specificity and predictive values)

Topics covered by practical demonstrations include:

> BPPV testing and particle re-positioning manoeuvres

> From the bedside: interview, eye examination, postural examination, head shake test and head impulse test

> VNG, ocular motor testing and caloric testing

> Vestibular rehabilitation

> VEMPs

Learning and Teaching

Teaching and learning methods

The module primarily consists of a series of small-group tutorials based around pre-recorded lectures and self-directed specific learning tasks, supported by full group plenary and Q&A sessions, case discussions and practical demonstration sessions.

Study time
Type	Hours
Tutorial	12
Completion of assessment task	2
Revision	34
Demonstration	8
Wider reading or practice	34
Seminar	6
Preparation for scheduled sessions	48
Teaching	6
Total study time	150

Assessment

Assessment strategy

.

Summative

This is how we’ll formally assess what you have learned in this module.

Breakdown
Method	Percentage contribution
Final Assessment	100%

Referral

This is how we’ll assess you if you don’t meet the criteria to pass this module.

Breakdown
Method	Percentage contribution
Final Assessment	100%

Repeat

An internal repeat is where you take all of your modules again, including any you passed. An external repeat is where you only re-take the modules you failed.

Breakdown
Method	Percentage contribution
Final Assessment	100%

Repeat Information

Repeat type: Internal & External