David Newman-Toker, neuro-otology
Senior author of "HINTS to diagnose stroke"
1/
What is dizziness?
-Dizziness→ impaired perception of spatial orientation without vertigo
-Vertigo→ illusion of motion (spinning/non-spinning)
>Subjective (person)→ MC peripheral
>Objective (environment)→ MC central
2/
-Oscillopsia→ 'world bounces'
>can’t read signs while walking
>B/L vestibular hypofunction
-Lightheadness, syncope→ LOC
-Imbalance→ severe truncal ataxia
3/
"Involuntary movements on one side that mirror voluntary actions on the other"
-Normal in <7–10yo (corpus callosum myelination), 70% healthy children (on speed-based task)
2/
Pathophysiology
Three teories
-Overflow
> signal 'overflows' to the other hand
-Weak interhemispheric inhibition
> both hemispheres fire together
-Abnormal crossing motor pathways
>same commands go to both hands
What EXACTLY happened before, during, and after the event?
-open-ended quest at begining, than close
-LOC, incotinence
-Witness and recurrence
*avoid term fainting
-Triggers (sleep dep, drugs, stand) vs premonitory symptoms