DynamicVisual AcuityUsedforbilateralvestibularweakness>VisualacuitycheckedonSnellenchart>Recheckedwhilerotatingheadbackandforth at 1-2 Hz>Lossof2-3linesconsideredabnormal
Dynamic Visual Acuity ➢ Used for bilateral vestibular weakness ➢ Visual acuity checked on Snellen chart ➢ Rechecked while rotating head back and forth at 1-2 Hz. ➢ Loss of 2-3 lines considered abnormal
RombergTest>Patientaskedto standwithfeettogetherand eyesclosed>Fallorstepispositivetest>Equal swaywitheyesopenand closedsuggestsproprioceptiveorcerebellarsite>More swaywith eyesclosed suggestsvestibularweakness
Romberg Test ➢ Patient asked to stand with feet together and eyes closed ➢ Fall or step is positive test ➢ Equal sway with eyes open and closed suggests proprioceptive or cerebellar site ➢ More sway with eyes closed suggests vestibular weakness
Romberg Test
Romberg Test
Fukuda SteppingTest>Originally describedbyFukudausing100stepsonamarkedfloor.>Patients are askedtostepwitheyes closed andhandsoutinfront>Rotationbymorethan45degreesisabnormalRotationusuallyoccurstothesideofthelesion>Rotation oftenfound in asymptomatic patients
Fukuda Stepping Test ➢ Originally described by Fukuda using 100 steps on a marked floor. ➢ Patients are asked to step with eyes closed and hands out in front ➢ Rotation by more than 45 degrees is abnormal ➢ Rotation usually occurs to the side of the lesion ➢ Rotation often found in asymptomatic patients
Dysdiadochokinesia Testing>MostcommonlytestedwiththehandslappingtestAbnormalitiesseeninpatientswithcerebellardysfunction>Poorsensitivityandspecificity
Dysdiadochokinesia Testing ➢ Most commonly tested with the hand slapping test ➢ Abnormalities seen in patients with cerebellar dysfunction ➢ Poor sensitivity and specificity