Clinical Management of Vertigo With Concurrent Acute Traumatic Brain Injury
Section: Academy of Acute Care PT
Session Code: AC-2B-8217
Date: Friday, January 25, 2019
Time: 11:00 AM - 1:00 PM
Location: Walter E. Washington Convention Center
Session Type: Educational Sessions
Session Level: Intermediate
This session will present an evidence-based approach to vestibular rehabilitation for individuals with traumatic brain injury (TBI). In the acute care setting, patients with traumatic brain injury present with a complex array of critical illness, concomitant injuries, and mobility limitations. Patients with more severe TBI can be nonverbal, aphasic, or confused, forcing PTs to rely more heavily on objective findings than subjective reports. Vertigo is a common symptom that occurs in up to 80% of people after TBI. Benign paroxysmal positional vertigo (BPPV) is frequently encountered in the acute care setting, but patients presenting with TBI in the hospital setting often are not screened for vestibular sequelae. PT examination and evaluation at bedside can be instrumental in defining the etiology and guiding quick and effective treatment.
Recent evidence indicates that patients with TBI and concurrent BPPV have similar resolution and recurrence rates as non-traumatic BPPV cases, and can be treated for single canal involvement with 1-2 canalith repositioning maneuvers. However, patients with TBI may require additional overall treatment time secondary to a higher incidence of multi-canal involvement and vague symptom report, and they may require altered positioning for effective assessment and treatment. The speakers will discuss dizziness and BBPV post TBI and identify components of vestibular assessment appropriate for the acute care setting. Attendees will learn to apply clinical reasoning to identify red flags and select appropriate means of vestibular rehabilitation management to guide the plan of care and discharge plan for patients with TBI.
Learning Objectives: Upon completion of this course, you will be able to:
1. Compare and contrast the pathophysiology involved with central versus peripheral vertigo in patients with an acute traumatic brain injury.
2. Identify the barriers of vestibular assessment in patients presenting with acute traumatic brain injury in the hospital setting.
3. Identify clinical reasoning and red flags in order to guide clinical assessment of patients presenting with vestibular symptoms in the hospital setting.
4. Discuss primary vestibular rehabilitation treatment principles and determine impact on overall plan of care and discharge planning.
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