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Samenvatting Neurological Physiotherapy 3
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Uitgebreide samenvatting van alle lessen Neurological Physiotherapy 3 (Vereeck, Brugghemans, Van Aggelpoel, Van Criekinge, Vanroy, Swinnen)
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Universiteit AntwerpenAcademiejaar 2020 - 2021
Faculteit Geneeskunde en Gezondheidswetenschappen
Master Revalidatiewetenschappen en Kinesitherapie
Neurological Physiotherapy 3
1
,VESTIBULAIRE REVALIDATIE
2
,INHOUD
1. Anatomie en fysiologie van het vestibulair apparaat.......................................................................... 5
1.1. Componenten en taken van het vestibulair systeem................................................................... 5
1.1.1. Proprioceptie ......................................................................................................................... 7
1.2.1. Visus....................................................................................................................................... 8
1.1.3. Het labyrint .......................................................................................................................... 11
1.2. Het labyrint ................................................................................................................................. 15
1.3. Vestibulo-Oculaire Reflex (VOR)................................................................................................. 24
1.4. Vestibulo-Spinale Reflex (VSR) ................................................................................................... 29
1.5. Vestibulo-autonoom systeem .................................................................................................... 30
1.6. Vestibulo-corticale of vestibulo-perceptuele systemen ............................................................ 31
1.7. Bijdrage van het centrale vestibulaire systeem (CVS) ................................................................ 33
1.7.1. Cutoff gedrag ....................................................................................................................... 37
1.7.2. Motion sickness ................................................................................................................... 38
1.7.3. Herstel ................................................................................................................................. 39
2. Vertigo en duizeligheid - oorzaken en aandoeningen van het vestibulair systeem.......................... 40
2.1. Wat is duizeligheid?.................................................................................................................... 40
2.2. Oorzaken van (vertigo) duizeligheid? ......................................................................................... 41
2.3. Nystagmus .................................................................................................................................. 42
2.3.1. Definitie ............................................................................................................................... 42
2.3.2. Observatie met of zonder onderdrukking van visuele fixatie ............................................. 42
2.3.3. Classificatie .......................................................................................................................... 44
2.4. Aandoeningen van het vestibulair apparaat .............................................................................. 46
2.4.1. Perifeer vestibulaire aandoeningen .................................................................................... 46
2.4.2. Centraal vestibulaire aandoeningen ................................................................................... 47
2.4.3. Mengeling perifeer/ centraal .............................................................................................. 48
2.5. Aandoeningen van het niet-vestibulair apparaat....................................................................... 49
2.7. Rol van de kinesitherapeut? ....................................................................................................... 49
2.7.1. Patroonherkenning.............................................................................................................. 49
3. Beoordeling van duizeligheid en participatiebeperkingen bij patiënten met een vestibulaire
aandoening ............................................................................................................................................ 54
4. Beoordeling van de VOR bij patiënten met een perifeer vestibulaire dysfunctie ............................ 59
4.1. Laboratorium testen................................................................................................................... 60
4.1.1. Elektronystagmografie (ENG) .............................................................................................. 60
4.1.2. Video-oculoscopie en video-oculografie ............................................................................. 65
4.1.3. Sclerale zoekspoelstest........................................................................................................ 65
3
, 4.1.4. Unilateral centrifugation test .............................................................................................. 66
4.1.5. Retinal Image Slip velocity ................................................................................................... 66
4.1.6. Vestibular Evoked Myogenic Potentials (VEMP) ................................................................. 66
4.1.7. Subjectieve Visuele Verticale test ....................................................................................... 66
4.2. Klinische ‘bedside’ testen ........................................................................................................... 67
4.2.1. Halmagyi Head Thrust Test (HHTT) ..................................................................................... 67
4.2.2. Head shaking test (Barany).................................................................................................. 70
4.2.3. Dynamic Visual Acuity test (DVA test) ................................................................................. 71
4.2.4. VOR cancellation test .......................................................................................................... 72
4.2.5. (Dix-Hallpike test, Side lying test, Roll test)......................................................................... 72
6. Beoordeling en behandeling van patiënten met Beninge Paroxysmale Positionele Vertigo............ 73
6.1. Definitie ...................................................................................................................................... 73
6.2. Epidemiologie ............................................................................................................................. 73
6.3. Etiologie/ pathogenese .............................................................................................................. 74
6.4. Tekenen en symptomen ............................................................................................................. 76
6.5. Beoordeling ................................................................................................................................ 77
6.5.1. Dix-Hallpike test .................................................................................................................. 78
6.5.2. Side lying test ...................................................................................................................... 81
6.5.3. Roll test ................................................................................................................................ 82
6.6. Behandeling ................................................................................................................................ 84
6.6.1. Single treatment approach .................................................................................................. 85
6.6.2. Habituatie (compensatie) .................................................................................................... 93
6.7. Complicaties ............................................................................................................................... 94
6.8. Effectiviteit ................................................................................................................................. 95
7. centrale Vestibulaire aandoeningen ................................................................................................. 99
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