TorontoPMR 2018 - 13:30-13:50 - Approach to Dizziness Following Traumatic Brain Injury

Approach to Dizziness Following Traumatic Brain Injury
^{Friday, November 16th 13:30-13:50}
Speaker: Dr. John Rutka, Professor Department of Otolaryngology-Head and Neck Surgery, University of Toronto, University Health Network

Description:

Headaches, neuropsychological/neurocognitive complaints and dizziness are common findings post head injury.-- This presentation will concentrate on a tailored approach to the history, physical examination and then necessary laboratory inner ear investigations required for the management of the dizzy patient post head injury. Special attention will be focussed on the clinical neurological provoking tests and management of benign position paroxysmal vertigo (BPPV) which is the most common organic peripheral vestibular disorder identified post head injury. Physical therapy manoeuvres for the management of BPPV are demonstrated. Surgical treatment for those with incapacitating BPPV recalcitrant to medical management and for canal dehiscent syndromes post trauma are demonstrated additionally-- Unique findings from a prospective series of > 4,000 head injured workers with "dizziness" referred from the Workplace Safety and Insurance Board (WSIB) since 1988 are presented. The mechanism of injury ( fall, contusion, explosion etc), class of injury (blunt, penetrating, accelerating/decelerating etc), its severity (minor, closed, closed with skull # etc), whether there was an associated loss of consciousness, imaging findings etc have been studied. Overall approximately 20% were identified to have neurotological abnormalities in this series. The common diagnoses made in those with post head injury dizziness is noted.-- There were quite significant differences in the presence of organic pathology depending on the profession involved. Controversial areas such as the development of Meniere's disease post trauma/differing resilience levels in certain professionals, assault in the workplace, the most dangerous jobs in Ontario etc are discussed.

Objectives: At the end of the session, the participants will be able to...
-- 1. Determine the important features necessary for the history and physical examination of the ""dizzy"" patient.
-- 2. List the necessary vestibular function tests for investigation of the dizzy patient.
-- 3. Compare and contrast different physical therapy manoeuvres for the treatment of BPPV.
-- 4. Compare the resilience of different professions with dizziness following head injury.
-- 5. Summarize the common causes for dizziness post head injury.
-- 6. Explain features that suggest a peripheral vestibular cause for an individual's post head injury dizziness

Question Title

* 1. Please rate the session:

	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	N/A
The session met my expectations.	The session met my expectations. Strongly Disagree	The session met my expectations. Disagree	The session met my expectations. Neutral	The session met my expectations. Agree	The session met my expectations. Strongly Agree	The session met my expectations. N/A
The audio visuals and related materials were well chosen and of good quality.	The audio visuals and related materials were well chosen and of good quality. Strongly Disagree	The audio visuals and related materials were well chosen and of good quality. Disagree	The audio visuals and related materials were well chosen and of good quality. Neutral	The audio visuals and related materials were well chosen and of good quality. Agree	The audio visuals and related materials were well chosen and of good quality. Strongly Agree	The audio visuals and related materials were well chosen and of good quality. N/A
There was adequate time for questions/discussion and evaluation.	There was adequate time for questions/discussion and evaluation. Strongly Disagree	There was adequate time for questions/discussion and evaluation. Disagree	There was adequate time for questions/discussion and evaluation. Neutral	There was adequate time for questions/discussion and evaluation. Agree	There was adequate time for questions/discussion and evaluation. Strongly Agree	There was adequate time for questions/discussion and evaluation. N/A
I gained new knowledge and skills.	I gained new knowledge and skills. Strongly Disagree	I gained new knowledge and skills. Disagree	I gained new knowledge and skills. Neutral	I gained new knowledge and skills. Agree	I gained new knowledge and skills. Strongly Agree	I gained new knowledge and skills. N/A
The session was free from commercial bias.	The session was free from commercial bias. Strongly Disagree	The session was free from commercial bias. Disagree	The session was free from commercial bias. Neutral	The session was free from commercial bias. Agree	The session was free from commercial bias. Strongly Agree	The session was free from commercial bias. N/A

Question Title

* 2. Please rate the speaker: John Rutka

	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	N/A
The speaker demonstrated thorough knowledge about the topic and established a good rapport with the audience.	The speaker demonstrated thorough knowledge about the topic and established a good rapport with the audience. Strongly Disagree	The speaker demonstrated thorough knowledge about the topic and established a good rapport with the audience. Disagree	The speaker demonstrated thorough knowledge about the topic and established a good rapport with the audience. Neutral	The speaker demonstrated thorough knowledge about the topic and established a good rapport with the audience. Agree	The speaker demonstrated thorough knowledge about the topic and established a good rapport with the audience. Strongly Agree	The speaker demonstrated thorough knowledge about the topic and established a good rapport with the audience. N/A
The objectives were adequately met and the speaker stimulated enthusiasm about the topic.	The objectives were adequately met and the speaker stimulated enthusiasm about the topic. Strongly Disagree	The objectives were adequately met and the speaker stimulated enthusiasm about the topic. Disagree	The objectives were adequately met and the speaker stimulated enthusiasm about the topic. Neutral	The objectives were adequately met and the speaker stimulated enthusiasm about the topic. Agree	The objectives were adequately met and the speaker stimulated enthusiasm about the topic. Strongly Agree	The objectives were adequately met and the speaker stimulated enthusiasm about the topic. N/A
The speaker was well informed, spoke clearly, managed time well and answered questions satisfactorily (an overall assessment is requested).	The speaker was well informed, spoke clearly, managed time well and answered questions satisfactorily (an overall assessment is requested). Strongly Disagree	The speaker was well informed, spoke clearly, managed time well and answered questions satisfactorily (an overall assessment is requested). Disagree	The speaker was well informed, spoke clearly, managed time well and answered questions satisfactorily (an overall assessment is requested). Neutral	The speaker was well informed, spoke clearly, managed time well and answered questions satisfactorily (an overall assessment is requested). Agree	The speaker was well informed, spoke clearly, managed time well and answered questions satisfactorily (an overall assessment is requested). Strongly Agree	The speaker was well informed, spoke clearly, managed time well and answered questions satisfactorily (an overall assessment is requested). N/A
The facilitator was prepared, managed time well and encouraged participation and evaluation.	The facilitator was prepared, managed time well and encouraged participation and evaluation. Strongly Disagree	The facilitator was prepared, managed time well and encouraged participation and evaluation. Disagree	The facilitator was prepared, managed time well and encouraged participation and evaluation. Neutral	The facilitator was prepared, managed time well and encouraged participation and evaluation. Agree	The facilitator was prepared, managed time well and encouraged participation and evaluation. Strongly Agree	The facilitator was prepared, managed time well and encouraged participation and evaluation. N/A

Question Title

* 3. As a result of attending this session I am planning to: (Check all that apply)

a) Discuss the session with my colleagues.

b) Pursue additional learning activities.

c) Complete a Personal Learning Project.

d) Change my practice.
Please explain the change you are planning to make or the learning you plan to complete (if applicable):

Question Title

* 4. Other comments/suggestions/topics for future meetings:

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