Telehealth For Patients with Vestibular Disorder

The AAN has produced a specialized guide to help you perform an examination of patients with a vestibular disorder via telehealth. This resource is formatted as a decision tree to outline an approach to the real-time audiovisual examination of a patient presenting with dizziness,¹ vertigo,¹ and/or unsteadiness,² assuming that prominent sensory and/or motor symptoms are absent (i.e., the etiology is unlikely to be myelopathy, neuropathy, etc.).

ACCESS THE GUIDE

Below are links to demonstrations of the complete virtual vestibular and ocular motor examinations that are referenced in this guide. Each video is accompanied by detailed descriptions with additional diagnostic information to help determine what is normal and abnormal, and what your findings mean.

Access The Complete Virtual Vestibular Examination

Access The Complete Virtual Ocular Motor Examination

The videos in this guide were developed by Daniel Gold, DO, Associate Professor of Neurology, Ophthalmology, Neurosurgery, Otolaryngology—Head & Neck Surgery, Emergency Medicine, and Medicine Division of Neuro-Visual & Vestibular Disorders, Johns Hopkins Hospital; and Olwen Murphy, MBBCh, MD, MRCPI, Assistant Professor of Neurology, Department of Neurology, Johns Hopkins University School of Medicine, Johns Hopkins Hospital.

¹Although the terms ‘vertigo’ (false sense of motion, spinning or non-spinning) and ‘dizzy’ (spatial disorientation without false sense of motion) have specific definitions, the symptom quality should not be overemphasized—e.g., either can be caused by a posterior fossa stroke or cardiac arrhythmia.^a

²Unsteadiness is defined as a feeling of being unstable without a directional preference while sitting, standing of walking.^a

^aBisdorff A, Von Brevern M, Lempert T, Newman-Toker DE. Classification of vestibular symptoms: towards an
international classification of vestibular disorders. J Vestib Res. 2009;19(1-2):1-13.