TandemGaitTestPatientsareaskedtowalkhealtotoeinastraightline orina circleComplexfunctionevaluatesmanyaspectsofbalancePoorperformanceseenincerebellarlesions,butcanbeseeninmanydisorders>Poorsensitivityand specificity
Tandem Gait Test ➢ Patients are asked to walk heal to toe in a straight line or in a circle ➢ Complex function evaluates many aspects of balance ➢ Poor performance seen in cerebellar lesions, but can be seen in many disorders ➢ Poor sensitivity and specificity
OrthostaticHypotension>MostofteninpatientsonBPmedswith“lightheadedness"on sittingto standing>DefinedasdropofSBP2OmmHGorDPB10mmHGwithin3minutesof standing>Tiltexamsofferobjectivemeasurementswithwellestablishednorms>Patientswithno symptomswill often“Tilt
Orthostatic Hypotension ➢ Most often in patients on BP meds with “light headedness” on sitting to standing ➢ Defined as drop of SBP 20mm HG or DPB 10mm HG within 3 minutes of standing ➢ Tilt exams offer objective measurements with well established norms ➢ Patients with no symptoms will often “Tilt
Voluntary Hyperventilation>Patientsaskedtooverbreathefor90secondsto3minutes>Hyperventilationcausessymptomsinsomeanxietydisorders>Mayprovokesymptomsinnormal>Poortestforvestibulardiagnosis
Voluntary Hyperventilation ➢ Patients asked to over breathe for 90 seconds to 3 minutes ➢ Hyperventilation causes symptoms in some anxiety disorders ➢ May provoke symptoms in normal ➢ Poor test for vestibular diagnosis