Subject »
d. Bedside examination

-  CLINICAL EXAMINATION SKILLS
-  -  Clinical examination of postural stability and gait
-  -  -  Romberg
4 3 4 4 4 4 4 4
-  -  -  Romberg/tandem
4 3 4 4 4 4 4 4
-  -  -  Tandem gait
4 3 4 4 4 4 4 4
-  -  -  Push test
4 2 4 4 4 4 4 4
-  -  -  Slow and fast gait
4 2 4 4 4 4 4 4
-  -  -  Turning
4 2 4 4 4 4 4 4
-  -  Clinical oculomotor examination
-  -  -  Alignment in primary gaze
4 3 4 2 4 4 4 2
-  -  -  Monocular occlusion (congenital latent nystagmus)
4 3 4 1 4 4 4 1
-  -  -  Cover / Uncover test
4 3 4 2 4 4 4 2
-  -  -  Alternating-cover test
4 3 4 2 4 4 4 2
-  -  -  Gaze and ocular motility in all cardinal directions
4 3 4 2 4 4 4 2
-  -  -  Pursuit
4 3 4 3 4 4 4 4
-  -  -  Vergence
4 2 4 2 4 4 4 3
-  -  -  Saccades horizontal/vertical
4 2 4 2 4 4 4 3
-  -  -  Head impulse test for lateral semicircular canal
4 4 4 4 4 4 4 4
-  -  -  Visual-vestibulo-ocular reflex (VVOR)
3 2 3 2 4 4 4 3
-  -  -  Head tilt and ocular torsion
3 3 3 1 4 4 4 1
-  -  -  Fixation removal (video or Frenzel goggles):
-  -  -  Visual suppression VOR
4 4 4 4 4 4 4 4
-  -  -  -  Center and eccentric gaze
4 4 4 3 4 4 4 3
-  -  -  -  Visual suppression VOR
4 4 4 3 4 4 4 3
-  -  -  - 
3 4 4 2 3 4 4 2

Open Access: Yes


Castellucci, A., Botti, C., Bettini, M., Fernandez, I. J., Malara, P., Martellucci, S., Crocetta, F. M., Fornaciari, M., Lusetti, F., Renna, L., Bianchin, G., Armato, E., & Ghidini, A. (2021). Case Report: Could Hennebert’s Sign Be Evoked Despite Global Vestibular Impairment on Video Head Impulse Test? Considerations Upon Pathomechanisms Underlying Pressure-Induced Nystagmus due to Labyrinthine Fistula. Frontiers in Neurology, 12. https://doi.org/10.3389/fneur.2021.634782

Link
https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2021.634782/full

Description
This article provides a comprehensive overview of Hennebert's sign due to labyrinthine fistula

Keywords
fistula, perilymphatic, pressure, tragal compression, Hennebert, fistula sign, pressure-induced nystagmus

Reviewer
Raymond van de Berg

Topics
-  -  -  -  Valsalva (nose pinch and glottic)
3 4 4 2 3 4 4 2
-  -  -  -  Mastoid/skull vibration
3 3 3 3 4 4 4 4
-  -  -  -  Head shaking
3 3 3 3 4 4 4 4
-  -  -  -  Hyperventilation
3 3 3 2 4 4 4 2
-  -  Positional testing
-  -  -  Dix Hallpike maneuver (right and left hanging head position)
4 4 4 4 4 4 4 4
-  -  -  Supine roll test
4 4 4 4 4 4 4 4
-  -  -  Bow and lean test
3 3 3 4 3 3 3 4
-  -  -  Diagnosing benign positional nystagmus variants
NA NA NA NA 4 4 4 4
-  -  -  Diagnosing central positional nystagmus
NA NA NA NA 4 4 4 3
-  -  Neuro-ophthalmological examination
-  -  -  Pupillary examination (pupillary reaction, swinging light test, convergence)
4 3 4 1 4 4 4 1
-  -  -  SVV testing (e.g. bucket test)
3 2 4 3 3 3 3 4
-  -  -  Ophthalmoscopy with occlusion of non-examined eye
2 1 2 1 2 1 2 1
-  -  -  Optokinetic nystagmus
3 2 3 2 3 3 3 2
-  -  -  Maddox Rod (incl. Skew vs oblique paresis)
2 2 2 1 1 1 1 1
-  -  -  Use of prisms
2 1 2 NA 1 1 1 NA
-  -  Auditory testing
-  -  -  Examination of the external ear (including shape (microtia, atresia, lop, etc.), pre-auricular pits)
2 4 4 1 4 4 4 1
-  -  -  Otoscopy
2 4 3 NA 2 4 3 NA
-  -  -  Weber and Rinne test
2 4 4 2 3 4 4 2
-  -  Other
-  -  -  Testing for orthostatic hypotension (lying down, 1min and 3mins after standing up: Schellong test)
3 3 3 3 4 4 4 4
-  -  -  Blood pressure measurement of the two arms
3 3 3 3 4 4 4 4
-  -  -  Facial nerve evaluation
4 4 3 2 4 4 3 2
-  -  Pediatric aspects of clinical examination skills
-  -  -  Awareness of age-related adaptation of clinical examination (e.g. use a game for testing)
2 3 4 3 NA NA NA NA
-  FINDINGS OF CLINICAL EXAMINATION
-  -  Oculomotor signs
-  -  -  Third, fourth and sixth cranial nerve palsies
4 2 4 2 3 2 3 3
-  -  -  Skew deviation and ocular tilt reaction
3 3 3 2 4 4 4 4
-  -  -  Internuclear ophthalmoplegia
3 2 3 3 4 2 4 4
-  -  -  One and a half syndrome
3 2 3 1 4 2 4 1
-  -  -  Convergence insufficiency
3 2 3 2 3 2 3 3
-  -  -  Decompensation of phorias
3 2 3 2 2 1 2 2
-  -  -  Spasm of the near triad
3 2 2 1 2 1 2 1
-  -  -  Limitations of ductions (including thyroid eye disease, congenital fibrosis of extra-ocular muscles)
3 2 2 1 3 2 3 1
-  -  -  Congenital miswiring syndromes (Duane’s syndrome, Moebius syndrome)
3 2 2 NA 3 2 3 NA
-  -  -  Supranuclear palsies
3 2 2 1 4 2 4 1
-  -  -  Ocular motor apraxia
3 2 2 1 3 2 3 1
-  -  -  Monocular elevation paralysis
3 2 2 1 3 2 3 1
-  -  Nystagmus and disorders of ocular stability
-  -  -  Nystagmus trajectory: reference frames, planes and directions
-  -  -  - 
4 4 4 2 NA NA NA NA

Open Access: Yes


Eggers, S. D., Bisdorff, A., Von Brevern, M., Zee, D. S., Kim, J., Perez-Fernandez, N., Welgampola, M. S., Della Santina, C. C., & Newman-Toker, D. E. (2019). Classification of vestibular signs and examination techniques: Nystagmus and nystagmus-like movements. Journal of Vestibular Research, 29(2–3), 57–87. https://doi.org/10.3233/ves-190658

Link
https://content.iospress.com/articles/journal-of-vestibular-research/ves190658

Description
This article presents a classification and definitions for types of nystagmus and other oscillatory eye movements

Keywords
nystagmus, upbeat, downbeat, torsional, end-point, optokinetic, magnetic, spontaneous, recovery, direction-fixed, periodic alternating, latent, infantile, oculopalatal, oculomasticatory, seesaw, epileptic, pursuit-paretic, gaze-evoked, gaze, gaze holding, degree, rebound, centripetal, positional, headshaking, cross-coupled, sound-induced, valsalva, pressure, vibration, hyperventilation, pursuit, saccadic intrusion, osscilation, square-wave jerks, macrosaccadic, opsoclonus, convergence-retraction, bobbing, myokymia, superior oblique, ping-pong, gaze, pendular, physiologic

Reviewer
Raymond van de Berg

Topics
-  -  -  - 
4 4 4 4 4 4 4 4

Open Access: Yes


Eggers, S. D., Bisdorff, A., Von Brevern, M., Zee, D. S., Kim, J., Perez-Fernandez, N., Welgampola, M. S., Della Santina, C. C., & Newman-Toker, D. E. (2019). Classification of vestibular signs and examination techniques: Nystagmus and nystagmus-like movements. Journal of Vestibular Research, 29(2–3), 57–87. https://doi.org/10.3233/ves-190658

Link
https://content.iospress.com/articles/journal-of-vestibular-research/ves190658

Description
This article presents a classification and definitions for types of nystagmus and other oscillatory eye movements

Keywords
nystagmus, upbeat, downbeat, torsional, end-point, optokinetic, magnetic, spontaneous, recovery, direction-fixed, periodic alternating, latent, infantile, oculopalatal, oculomasticatory, seesaw, epileptic, pursuit-paretic, gaze-evoked, gaze, gaze holding, degree, rebound, centripetal, positional, headshaking, cross-coupled, sound-induced, valsalva, pressure, vibration, hyperventilation, pursuit, saccadic intrusion, osscilation, square-wave jerks, macrosaccadic, opsoclonus, convergence-retraction, bobbing, myokymia, superior oblique, ping-pong, gaze, pendular, physiologic

Reviewer
Raymond van de Berg

Topics
-  -  -  - 
4 4 4 2 4 4 4 2

Open Access: Yes


Eggers, S. D., Bisdorff, A., Von Brevern, M., Zee, D. S., Kim, J., Perez-Fernandez, N., Welgampola, M. S., Della Santina, C. C., & Newman-Toker, D. E. (2019). Classification of vestibular signs and examination techniques: Nystagmus and nystagmus-like movements. Journal of Vestibular Research, 29(2–3), 57–87. https://doi.org/10.3233/ves-190658

Link
https://content.iospress.com/articles/journal-of-vestibular-research/ves190658

Description
This article presents a classification and definitions for types of nystagmus and other oscillatory eye movements

Keywords
nystagmus, upbeat, downbeat, torsional, end-point, optokinetic, magnetic, spontaneous, recovery, direction-fixed, periodic alternating, latent, infantile, oculopalatal, oculomasticatory, seesaw, epileptic, pursuit-paretic, gaze-evoked, gaze, gaze holding, degree, rebound, centripetal, positional, headshaking, cross-coupled, sound-induced, valsalva, pressure, vibration, hyperventilation, pursuit, saccadic intrusion, osscilation, square-wave jerks, macrosaccadic, opsoclonus, convergence-retraction, bobbing, myokymia, superior oblique, ping-pong, gaze, pendular, physiologic

Reviewer
Raymond van de Berg

Topics
-  -  -  - 
4 4 4 3 4 4 4 3

Open Access: Yes


Eggers, S. D., Bisdorff, A., Von Brevern, M., Zee, D. S., Kim, J., Perez-Fernandez, N., Welgampola, M. S., Della Santina, C. C., & Newman-Toker, D. E. (2019). Classification of vestibular signs and examination techniques: Nystagmus and nystagmus-like movements. Journal of Vestibular Research, 29(2–3), 57–87. https://doi.org/10.3233/ves-190658

Link
https://content.iospress.com/articles/journal-of-vestibular-research/ves190658

Description
This article presents a classification and definitions for types of nystagmus and other oscillatory eye movements

Keywords
nystagmus, upbeat, downbeat, torsional, end-point, optokinetic, magnetic, spontaneous, recovery, direction-fixed, periodic alternating, latent, infantile, oculopalatal, oculomasticatory, seesaw, epileptic, pursuit-paretic, gaze-evoked, gaze, gaze holding, degree, rebound, centripetal, positional, headshaking, cross-coupled, sound-induced, valsalva, pressure, vibration, hyperventilation, pursuit, saccadic intrusion, osscilation, square-wave jerks, macrosaccadic, opsoclonus, convergence-retraction, bobbing, myokymia, superior oblique, ping-pong, gaze, pendular, physiologic

Reviewer
Raymond van de Berg

Topics
-  -  -  Attributes of nystagmus
-  -  -  - 
4 4 4 3 4 4 4 4

Open Access: Yes


Eggers, S. D., Bisdorff, A., Von Brevern, M., Zee, D. S., Kim, J., Perez-Fernandez, N., Welgampola, M. S., Della Santina, C. C., & Newman-Toker, D. E. (2019). Classification of vestibular signs and examination techniques: Nystagmus and nystagmus-like movements. Journal of Vestibular Research, 29(2–3), 57–87. https://doi.org/10.3233/ves-190658

Link
https://content.iospress.com/articles/journal-of-vestibular-research/ves190658

Description
This article presents a classification and definitions for types of nystagmus and other oscillatory eye movements

Keywords
nystagmus, upbeat, downbeat, torsional, end-point, optokinetic, magnetic, spontaneous, recovery, direction-fixed, periodic alternating, latent, infantile, oculopalatal, oculomasticatory, seesaw, epileptic, pursuit-paretic, gaze-evoked, gaze, gaze holding, degree, rebound, centripetal, positional, headshaking, cross-coupled, sound-induced, valsalva, pressure, vibration, hyperventilation, pursuit, saccadic intrusion, osscilation, square-wave jerks, macrosaccadic, opsoclonus, convergence-retraction, bobbing, myokymia, superior oblique, ping-pong, gaze, pendular, physiologic

Reviewer
Raymond van de Berg

Topics
-  -  -  -  Binocularity
4 4 4 1 4 4 4 1
-  -  -  -  Conjugacy (conjugate, disconjugate)
4 4 4 1 4 4 4 1
-  -  -  -  Velocity
4 4 4 2 4 4 4 2
-  -  -  -  Waveform (jerk, pendular)
4 4 4 2 4 4 4 3
-  -  -  -  Frequency
4 4 4 2 4 4 4 2
-  -  -  -  Amplitude
4 4 4 2 4 4 4 2
-  -  -  -  Intensity
4 4 4 2 4 4 4 2
-  -  -  -  Temporal profile (continuous, intermittent)
4 4 4 3 4 4 4 3
-  -  -  -  Age of first appearance (congenital, infantile)
3 3 4 2 NA NA NA NA
-  -  -  PHYSIOLOGIC NYSTAGMUS
-  -  -  -  Physiologic end-point nystagmus
4 4 4 4 4 4 4 4
-  -  -  -  Per-rotational nystagmus
4 4 4 3 4 4 4 3
-  -  -  -  Post-rotational nystagmus
4 4 4 3 4 4 4 3
-  -  -  -  Optokinetic nystagmus
4 4 4 3 4 4 4 3
-  -  -  -  Optokinetic after-nystagmus
3 3 3 2 2 2 2 2
-  -  -  -  Caloric nystagmus
4 4 4 4 4 4 4 4
-  -  -  -  Magnetic vestibular stimulation (MVS)-induced nystagmus
2 2 2 1 1 1 1 1
PATHOLOGIC NYSTAGMUS
-  -  -  -  Spontaneous nystagmus
-  -  -  -  -  Spontaneous peripheral vestibular nystagmus
-  -  -  -  -  Spontaneous peripheral vestibular nystagmus, inhibitory type
4 4 4 4 4 4 4 4
-  -  -  -  -  Spontaneous peripheral vestibular nystagmus, excitatory type
4 4 4 4 4 4 4 4
-  -  -  -  -  Recovery nystagmus
4 4 4 3 4 4 4 3
-  -  -  -  -  Spontaneous central vestibular nystagmus
-  -  -  -  Gaze-evoked nystagmus
-  -  -  -  -  Predominantly horizontal central vestibular nystagmus
-  -  -  -  -  Gaze-holding nystagmus (unilateral, bilateral, vertical)
3 3 3 3 4 4 4 3
-  -  -  -  -  Direction-fixed horizontal central vestibular nystagmus
4 3 4 3 3 3 3 3
-  -  -  -  -  First degree vestibular nystagmus
3 3 3 3 4 4 4 3
-  -  -  -  -  Periodic alternating nystagmus
4 3 4 3 3 3 3 3
-  -  -  -  -  Vestibular plus gaze-holding nystagmus
3 3 3 2 4 4 4 2
-  -  -  -  -  Latent nystagmus
4 3 4 2 4 3 4 2
-  -  -  -  -  Rebound nystagmus
3 3 3 3 3 3 3 3
-  -  -  -  -  Centripetal nystagmus
3 3 3 3 3 3 3 3
-  -  -  -  Triggered nystagmus
-  -  -  -  -  Predominantly vertical or torsional central vestibular nystagmus
-  -  -  -  -  Downbeat nystagmus
4 3 4 3 4 4 4 3
-  -  -  -  -  Upbeat nystagmus
4 3 4 3 4 4 4 3
-  -  -  -  -  Torsional nystagmus
4 3 4 3 4 4 4 3
-  -  -  -  -  Other spontaneous central nystagmus forms
-  -  -  -  -  Positional nystagmus
-  -  -  -  -  Infantile nystagmus
3 3 4 2 3 3 3 2
-  -  -  -  -  Benign paroxysmal positional nystagmus (BPPN)
-  -  -  -  -  Posterior semicircular canal BPPN
4 4 4 4 4 4 4 4
Horizontal semicircular canal BPPN
4 4 4 4 3 3 3 4
-  -  -  -  -  Pseudo-spontaneous nystagmus
-  -  -  -  -  Anterior semicircular canal BPPN
3 3 3 3 3 3 3 3
-  -  -  -  -  Other forms of peripheral positional nystagmus
3 3 3 3 3 3 3 3
-  -  -  -  -  Central positional nystagmus
4 3 3 3 4 3 4 3
-  -  -  -  -  Headshaking-induced nystagmus
3 3 3 4 4 4 4 4
-  -  -  -  -  Acquired pendular nystagmus
-  -  -  -  -  Oculopalatal tremor
3 3 3 2 3 3 3 2
-  -  -  -  -  Oculomasticatory myorhythmia
3 3 3 1 3 3 3 1
-  -  -  -  -  Cross-coupled nystagmus
3 3 3 3 4 4 4 3
-  -  -  -  -  Seesaw nystagmus
3 3 3 2 3 3 3 2
-  -  -  -  -  Sound-induced nystagmus
3 4 4 3 3 4 4 3
-  -  -  -  -  Epileptic nystagmus
3 3 3 1 3 2 2 1
-  -  -  -  -  Valsalva-induced nystagmus
3 4 4 3 3 4 4 3
-  -  -  -  -  Pursuit-paretic nystagmus
3 3 3 1 3 2 2 1
-  -  -  -  -  Pressure-induced nystagmus
3 4 4 3 3 4 4 3
-  -  -  -  -  Vibration-induced nystagmus
3 3 3 4 4 4 4 4
-  -  -  -  -  Hyperventilation-induced nystagmus
3 3 3 3 4 4 4 3
-  -  -  -  -  Pursuit-induced nystagmus
3 2 3 2 3 3 3 2
-  -  -  NYSTAGMUS-LIKE MOVEMENTS
-  -  -  -  Saccadic intrusions and oscillations
-  -  -  -  -  Square-wave jerks
3 3 3 3 4 4 4 3
-  -  -  -  -  Macrosaccadic oscillations
3 2 3 2 4 4 4 2
-  -  -  -  -  Saccadic pulses
3 2 3 2 3 2 2 2
-  -  -  -  -  Ocular flutter
4 3 4 2 3 3 3 2
-  -  -  -  -  Opsoclonus
4 3 4 2 4 4 4 2
-  -  -  -  -  Voluntary saccadic oscillations
3 3 3 2 3 3 3 2
-  -  -  -  Other nystagmus-like movements
-  -  -  -  -  Convergence-retraction nystagmus
3 2 3 1 3 2 2 1
-  -  -  -  -  Ocular oscillations in spasmus nutans
3 2 3 1 2 2 2 1
-  -  -  -  -  Ocular bobbing and its variants
3 2 3 1 3 2 2 1
-  -  -  -  -  Superior oblique myokymia
3 2 3 1 2 2 2 1
-  -  -  -  -  Ping-pong gaze
2 1 2 1 2 1 1 1
-  -  -  -  -  Pendular pseudonystagmus
3 2 3 1 3 1 1 1
-  -  Identify gait and movement patterns
-  -  -  Cautious
4 4 4 4 4 4 4 4
-  -  -  Cerebellar ataxia
4 3 3 4 4 2 3 4
-  -  -  Spastic ataxic
4 2 3 4 4 1 3 4
-  -  -  Extrapyramidal pattern
4 2 3 4 4 1 3 4
-  -  -  Neuro-muscular pattern
4 2 3 4 4 1 3 4
-  -  -  Apraxic pattern
4 2 3 4 4 1 3 4
-  -  -  Stepping
4 2 3 4 4 1 3 4
-  -  -  Pusher syndrome
4 2 3 4 4 2 3 4
-  -  -  Sensory / proprioceptive loss
4 2 3 4 4 2 3 4
-  -  -  Functional
4 3 3 4 4 2 3 4
-  -  Pediatric aspects of clinical examination findings
-  -  -  Motor developmental delay
2 2 4 4 2 2 2 4

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