Perceptual Postural Imbalance and Visual Vertigo
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Purpose of Review
Disorders of posture and balance cause significant patient morbidity, with reduction of quality of life as patients refrain from critical activities of daily living such as walking outside the home and driving. This review describes recent efforts to characterize visual disorders that interact with the neural integrators of positional maintenance and emerging therapies for these disorders.
Abnormalities of gait and body position sense may be unrecognized by patients but are correlated with focal neurological injury (stroke). Patients with traumatic brain injury can exhibit visual vertigo despite otherwise normal visual functioning.
The effect of visual neglect on posture and balance, even in the absence of a demonstrable visual field defect, has been characterized quantitatively through gait analysis and validates the potential therapeutic value of prism treatment in some patients. In addition, the underlying neural dysfunction in visual vertigo has been explored further using functional imaging, and these observations may allow discrimination of patients with structural causes from those whose co-morbid psychosocial disorders may be primarily contributory.
KeywordsPostural instability Vestibular imbalance Hemianopia Visual neglect Optic flow Visual vertigo
Jeffrey R. Hebert and Prem S. Subramanian would like to thank Aki Kawasaki for providing them with this topic.
This work was supported in part by a Challenge Grant to the Department of Ophthalmology, University of Colorado School of Medicine.
Compliance with Ethical Standards
Conflict of Interest
Jeffrey R. Hebert and Prem S. Subramanian each declare no potential conflicts of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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