Assessments

Physical Symptoms: (Rate the severity on a 1 -10 scale) 

Headache

Nausea / Vomiting

Dizziness / Balance problems

Visual problems

Fatigue

Sensitivity to Light

Sensitivity to Noise

Numbness / Tingling

Cognitive Symptoms: (Rate the severity on a 1 -10 scale)

Brain Fog 

Feeling slowed down

Difficulty concentrating

Difficulty remembering

Emotional Symptoms: (Rate the severity on a 1 -10 scale)

Irritability / Anger

Sadness / Depression

More Emotional / Sensitive

Nervousness / Anxiety

STEP 2 – Assess Sleep Status

Insomnia Symptoms: (Rate the severity on a 1 -10 scale)

Drowsy

Difficulty falling asleep

Difficulty staying asleep

Sleeping more than usual

Sleeping less than usual

STEP 3 – Assess Dizziness Status

Evaluate the impact of dizziness on daily life by measuring self-perceived handicap. 

Dizziness Problems: (Rate the severity on a 1 -10 scale)

Does dizziness increase with head or body movement?

Does dizziness affect your social life?

Does dizziness affect your physical mobility?

Does dizziness restrict your travels?

Does dizziness interfere with your job and/or household responsibilities?

Does dizziness affect your emotional state?

Does dizziness affect your relationships?

STEP 4 – Assess Anxiety Status

Evaluate the severity of anxiety by measuring the impact on daily life. 

Anxiety Concerns: (Rate the severity on a 1 -10 scale) 

Are you nervous, anxious or worrying too much?

Are you restless / trouble relaxing?

Are you easily angered or annoyed? 

Are you fearful?

TEST 1 – Vestibular Ocular Response [VOR]

… evaluate eye coordination and your balance in response to a challenging task.

DO NOT PERFORM if you have any of the following: recent head/neck injury, headache, dizzy, cold/flu, infection of ear/nose/throat, certain eye conditions.

Evaluation Procedure:

1) While seated, Rotate head side to side 3 times smoothly. (keep eyes open, use graded head rotation speed chart below)

2) Stop head rotations.
– Does your body sway? Are your eyes slow to re-focus?

3) Circle all observations experienced during testing:
– sway/poor balance – dizzy – headache
– slow/delayed visual focus – eye twitch – nausea

Graded head rotation speed: (Begin at grade one, proceed to the next grade when no findings are observed.)

Grade 1 = 1 rotation per second Grade 2 = 2 rotations per second Grade 3 = 4 rotations per second Grade 4 = 6+ rotations per second

VOR test 2024Download

<Insert link to video file: VOR perform.mov>

TEST 2 – The Bite Test  [Cranial Nerve 5]

… evaluate for a loss of strength of the jaw muscles on one side versus the other.

Physical Exam: (Rate the strength on a 1 -5 scale)

Clench the jaw tight on one side (use a popsicle stick if needed) to evaluate the power of the jaw muscles (called the Masseter muscle). Compare the strength to the other side of the jaw. The strength should be relatively even on both sides. The weak side indicates a possible issue with the 5th cranial nerve. 

TEST 3 – The Cheek Puff Test [Cranial Nerve 7]

… evaluate for a loss of strength of the cheek muscles on one side versus the other.

Physical Exam: (Rate the strength on a 1 -5 scale)

Puff the cheek out on one side. Push with your fingers to evaluate the power of the cheek muscles. Compare the strength to the other side of the face. The strength should be relatively even on both sides. The weak side indicates a possible issue with the 7th cranial nerve.

TEST 4 – The Uvula Test [Cranial Nerves 9 & 10]

… evaluate for a loss of strength of the muscles that elevate the uvula.  (Uvula = the little fleshy hanging ball in the back of your throat)

Physical Exam: (Rate the strength on a 1 -5 scale)

Use a mirror to visualize the movement of the uvula. Open the mouth and say, “Aah.”  Determine whether the palate elevates symmetrically and the uvula remains in the midline. If weakness is present, the uvula will lift away from the weak side. 

TEST 5 – The Tongue Test [Cranial Nerve 12]

… evaluate for a loss of strength of the muscles that control the tongue.

Physical Exam: (Rate the strength on a 1 -5 scale)

Press the tongue against each cheek while providing resistance to the cheek. Compare the strength on each side. They should have even strength.

TEST 6 – Basic Eye Function Test [Cranial Nerves 3, 4 & 6]

… evaluate for weakness of the muscles that control eye movements.

Physical Exam: (Rate the strength on a 1 -5 scale)

Part 1 – Without moving the head, look to the left for three seconds and evaluate for any strain. Compare the difficulty by looking to the right for three seconds. They should be relatively even on both sides.

Part 2 – Without moving the head, look upward for three seconds and evaluate for any strain. Compare the difficulty by looking downward for three seconds. They should be relatively even on both sides.

TEST 7 – The Jaw Function Test 

… evaluate for a loss of strength of the muscles that control jaw movements.

Physical Exam: (Rate the strength on a 1 -5 scale)

Without moving the head, shift the jaw to each side looking for weakness, clicking or popping. Without moving the head, jut the jaw forward looking for weakness, clicking or popping. Without moving the head, open the jaw as wide as possible looking for the jaw to shift to one side, weakness, clicking or popping.