Central Vestibular Disorders and HINTS Testing
Presented by Jeff Walter
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The course will review the features of central nervous system disorders that may present with vestibular-related issues. Content will include a detailed discussion of vertebrobasilar insufficiency, cerebellar-origin dizziness (including Chiari malformation), multiple sclerosis, and white matter disease. To enhance the clinician’s ability to recognize concerning examination findings, a series of video-based examples of CNS-origin ocular impairments will be reviewed. Indications, application, and interpretation of bedside HINTS will be reviewed to increase recognition of potentially sinister causes of vestibular symptoms. Video examples of the components of HINTS testing will be shared. The course is appropriate for audiologists and occupational/physical therapists and assistants.
Meet your instructor

Jeff Walter
Jeff Walter is the director of the Otolaryngology Vestibular and Balance Center at Geisinger Medical Center in Danville, Pennsylvania. His clinical practice focuses on vestibular diagnostic testing and vestibular rehabilitation. He is an assistant professor of physical therapy in the Neuroscience Institute at Geisinger…
Chapters & learning objectives

1. Central Vestibular Disorders
Content will include features of central nervous system (CNS) disorders that may present with vestibular-related issues. Recognition of concerning causes of vestibular symptoms and indications for further medical management is important for clinicians involved in vestibular testing and rehabilitation.

2. Traits of Central-Origin Oculomotor Findings
To enhance the clinician’s ability to recognize concerning examination findings, a series of video-based examples of CNS-origin ocular impairments will be reviewed. Common abnormalities noted with MS, stroke, cerebellar disorders, and parkinsonism-like disorders will be demonstrated. Recognition of red flags is important in alerting clinicians to a potentially more concerning cause of vestibular symptoms.

3. HINTS Testing
HINTS testing, which can be helpful in identifying a potentially sinister cause of symptoms in subjects with acute and ongoing vertigo, will be reviewed. The components of HINTS testing will be demonstrated, and video case examples will be presented.
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Central Vestibular Disorders and HINTS Testing
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Vestibular Examination: Oculomotor Testing
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Vestibular Examination: Postural Control Testing
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Vestibular Compensation Exercises and Clinical Resources
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Diagnostic Maneuvers for BPPV
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