Vestibular Glossary
Compiled by Jeff Walter PT, DPT, NCS
Acephalgic: Without head pain
Acrophobia: Fear of heights
Ageotropic: Movement tendency directed away from the earth
Agoraphobia: Fear of busy, open marketplaces
Alexander’s Law: Peripheral vestibular-origin nystagmus is enhanced with gaze directed toward the fast phase
Aminoglycosides: Group of antibiotics that can produce vestibular or cochlear toxicity
Ampulla: Dilated ending of the semicircular canal containing the cupula
Ampullofugal: Refers to displacement “away” from the ampulla
Ampullopetal: Refers to displacement “toward” the ampulla
Antihistamine: Class of medications utilized to address chronic vertigo or motion sickness
Antivert (Meclizine): Antihistamine used to promote vestibular sedation with chronic vertigo or motion sickness
Ataxia: incoordination
Ativan (Lorazepam): Benzodiazepine used to promote vestibular sedation with acute vertigo
Audiometry: Test of hearing
Autophony: Hearing of a person's own voice, breathing or other self-generated sounds
Barany Maneuver (aka Dix-Hallpike, Hallpike): Testing procedure intended to identify anterior or posterior canal BPPV
Benzodiazapines: Class of medications utilized to promote vestibular sedation with acute vertigo
Caloric Testing: Component of ENG/VNG testing, intended to assess for asymmetric horizontal canal / superior vestibular nerve function, that involves irrigation of warm and cold water or air into the external auditory canal
Canalithiasis: Variant of BPPV where otoconia are free floating within the semicircular canal
Canalith Repositioning Maneuvers: Treatments intended to move displaced otoconia from the affected semicircular canal to the utricle
Cephalgia: Head pain
Cerebellum: Portion of the hindbrain that modulates balance, limb and eye movements
Cholesteatoma: Mass growing within a confined space, often the middle ear
Cisplatnin: Chemotherapy agent with vestibular-toxic properties
Cochlea: Pertaining to the auditory portion of the labyrinthine organ
Collic: Referring to the neck
Cupulolithiasis: Variant of BPPV where otoconia are adherent to the cupula
Dehiscence: Refers to a split or opening in a structure
Diazepam (Valium): Benzodiazepine used to promote vestibular sedation
Dimenhydrinate (Dramamine): Antihistamine used to promote vestibular sedation with chronic vertigo or motion sickness
Diplopia: Double vision
Dix-Hallpike Maneuver (aka Barany, Hallpike): Testing procedure intended to identify anterior or posterior canal BPPV
Dizziness: Non-specific term encompassing feelings of imbalance, spinning and lightheadedness
Dramamine (Dimenhydrinate): Antihistamine used to promote vestibular sedation with chronic vertigo or motion sickness
Dysarthria: Difficulty articulating words
Dysequilibrium: Subjective sense of unsteadiness
Electronystagmography: Measurement of eye movements with electrodes surrounding the orbit
Emesis: vomit
Epley Maneuver: Treatment designed to address posterior canal BPPV
Ewald’s Laws
1st:: The axis of nystagmus parallels the anatomic axis of the semicircular canal that generated it.
2nd: Ampullopetal endolymphatic flow produces a stronger response than ampullofugal flow in the horizontal canal
Fistula (Perilymph): Abnormal opening between the fluid-filled inner ear and the air-filled middle ear
Fixation: Maintenance of gaze on a single location
Fovea: Center portion of the retina, the region of highest visual acuity
Frenzel googles: Utilized to block gaze fixation with the use of magnified lenses and illumination
Fukuda Step Test: Postural control test utilized to uncompensated unilateral vestibular loss
Fullness: Perception of pressure
Gentamycin: Antibiotic with vestibular-toxic properties
Geotropic: Movement tendency directed toward the earth
Habituation: An acquired tolerance gained by repeated exposure to a particular stimulus
Hallpike Maneuver (Barany, Dix-Hallpike): Testing procedure intended to identify anterior or posterior canal BPPV
Hydrops: Distention of the labyrinth with fluid, a likely component of Meniere’s Disease
Hyperacusis: Abnormally acute hearing
Imbalance: Observable unsteadiness
Labyrinth: Refers to the inner ear which includes the cochlea and vestibular organs
Latency: The time between the initiation of a stimulus and the clinical manifestation of the disease
Lateropulsion: Tendency to fall to the side
Lightheadedness: Feeling of faintness
Lorazepam (Ativan): Benzodiazepine used to promote vestibular sedation with acute vertigo
Otolithic Crisis of Tumarkin: A sudden unexplained fall without loss of consciousness or vertigo, attributed to an abrupt change in otolithic input
Maculae: Sensory epithelium contains hair cells that are stimulated by linear acceleration and deceleration within the otolithic organs
Mastoid: Bony prominence at the base of the skull behind the ear, containing air spaces that connect with the middle ear cavity
Meclizine (Antivert): Antihistamine used to promote vestibular sedation
Nystagmus: resets the eyes during prolonged rotation and directs gaze towards the oncoming visual scene
Ocular flutter: Bursts of saccadic activity that involve rapid, involuntary, uni-planar, conjugate eye movements around the point of fixation without an inter-saccadic interval
Ophthalmoplegia: Weakness of one or more of the eye muscles that control eye movment
Optikinetic: generates eye movements in response to sustained rotations of objects that encompass a large portion of the visual field
Opsoclonus: Bursts of saccadic activity that involves rapid, involuntary, non-rhythmic, multidirectional, conjugate eye movements without significant inter-saccadic interval.
Orthogonal: Intersecting at 90 degree angles
Ortostatic Tremor: Rhythmical muscle contractions present with standing
Oscillopsia: Gaze instability
Ossicles: Middle ear bones (malleus, incus and stapes) that transmit sound from the tympanic membrane to the oval window of the inner ears.
Otalgia: Pain in the ear
Otoconia: Calcium carbonate crystals embedded within the maculae within the otolith organs.
Otolithic Crisis of Tumarkin: Sudden, conscious falls that occur without warning likely due to inappropriate otolith activity
Otolith Organs: Refers to the utricle and saccule
Otoliths: Otoconia
Ototoxic: Having a harmful affect on labyrinthine structures
Paraneoplastic: Caused by the presence of cancer in the body but not the physical presence of cancerous tissue in the part or organ affected
Paroxysmal: Recurrent and sudden intensification of symptoms
Perilymph: Fluid situated between the bony and membranous labyrinth
Phenergan (Promethazine): Antihistamine utilized to address chronic vertigo and motion sickness
Phonophobia: Fear/sensitivity to sound
Photophobia: Fear/sensitivity to light
Pitch: To turn about a medial-lateral (y) axis
Promethazine (Phenergan): Antihistamine utilized to address chronic vertigo and motion sickness
Pulsion: The feeling of being pulled in a certain direction
Roll: To turn about an anterior-posterior (x) axis
Roll Test: Maneuver intended to identify horizontal canal BPPV
Saccades: Abrupt, rapid movement of both eyes utilized to change the point of fixation
Saccule: Otolithic organ that primarily detects vertical linear accelerations
Schwannoma: Solid, usually benign tumor derived from Schwann cells
Semicircular canal: Circular, fluid-filled, ducts within the vestibular organ responsible; structure promotes the detection of angular accelerations
Semont Maneuver: Treatment designed to address posterior canal BPPV, canalithiasis or cupulolithiasis
Smooth pursuit: Maintains image of a small moving target on the fovea
Stapedectomy: Surgical removal of the stapes followed by prosthetic replacement
Syncope: Loss of consciousness
Temporal Bone: Portion of the skull containing the labyrinth
Tinnitus: Ringing in the ears
Torsion: Rotation of the eye around a roll (anterior-posterior) axis
Tropia: Deviation in ocular alignment
Tulio’s Phenomena: Vestibular symptoms elicited by sound
Utricle: Otolithic organ that primarily detects horizontal linear accelerations
Utriculofugal: Refers to displacement away from the utricle
Utriculopetal: Refers to displacement toward the utricle
Valium (Diazepam): Benzodiazepine used to promote vestibular sedation
Valsalva Maneuver: Attempt to forcibly exhale with the glottis, nose and mouth closed
Vestibular-Evoked Myogenic Potential: Laboratory test of saccular / inferior vestibular nerve function
Vergence: Movement of the eyes in opposite directions used in adjusting to near or far vision
Vertigo: Dizziness characterized by a sense of spinning
Vestibular: Refers to the vestibular (balance) portion of the labyrinthine organ
Vestibulopathy: Disease to the vestibular organ
Visual fixation: Holds the image of a stationary object on the fovea by minimizing ocular drifts
Videonystagmography: Measurement of eye movements with the use of video
Yaw: To turn about a vertical (z) axis
Abbreviations
ABC: Activities specific Balance Confidence
BOS: Base Of Support
BPPV: Benign Paroxysmal Positional Vertigo
BVL: Bilateral Vestibular Loss
CD: Cerebellar Degeneration
CDP: Computerized Dynamic Posturography
COG: Center of Gravity
COR: Cervical-Ocular Reflex
CRT: Canaltih Repositioning Treatment
CRM: Canaltih Repositioning Maneuvers
CTSIB: Clinical Test of Sensory Interaction for Balance
DBN: DownBeat Nystagmus
DGI: Dynamic Gait Index
DHI: Dizziness Handicap Inventory
DVA: Dynamic Gait Index
ENG: ElectroNystagmoGraphy
GEN: Gaze-evoked nystagmus
HSN: Head-Shaking induced Nystagmus
IHS: International Headache Society
INO: InterNuclear Ophthalmaplegia
LVN: Lateral Vestibular Nucleus
MDD: Mal De Debarquement
MLF: Medial Longitudinal Fasiculus
MRD: Migraine Related Dizziness
MS: Multiple Sclerosis
MSQ: Motion Sensitivity Quotient
MVN: Medial Vestibular Nucleus
OKN: OptiKinetic Nystagmus
PAN: Periodic Alternating Nystagmus
PICA: Posterior Insferior Cerebellar Artery
POT: Primary Orthostatic Tremor
PPRF: ParaPontine Reticular Formation
SCC: SemiCircular Canal
SCD: Superior Canal Dehiscence
SNHL: Sensori-Neural Hearing Loss
SLS: Single Limb Stance
SOT: Sensory Organization Test
SVA: Static Visual Acuity
SWJ: Square Wave Jerks
TUG: Timed Up and Go
UVL: Unilateral Vestibular Loss
VBI: Vertebral-Basilar Insufficiency
VCR: Vestibulo-Collic Reflex
VEMPs: Vestibular Evoked Myogenic Potentials
VNG: VideoNystagmoGraphy
VOR: Vestibular-Ocular Reflex
VRT: Vestibular Rehabilitation Therapy
VSR: Vestibulo-Spinal Reflex