PT - JOURNAL ARTICLE AU - Tsang, K AU - Marcus, HJ AU - Paine, H AU - Sargeant, M AU - Jones, B AU - Smith, R AU - Wilson, MH AU - Seemungal, BM TI - TP1-9 Vestibular dysfunction in acute traumatic brain injury AID - 10.1136/jnnp-2019-ABN.38 DP - 2019 Mar 01 TA - Journal of Neurology, Neurosurgery & Psychiatry PG - e12--e12 VI - 90 IP - 3 4099 - http://jnnp.bmj.com/content/90/3/e12.2.short 4100 - http://jnnp.bmj.com/content/90/3/e12.2.full SO - J Neurol Neurosurg Psychiatry2019 Mar 01; 90 AB - Objectives Vestibular dysfunction following traumatic brain injury (TBI) is a major cause of morbidity and unemployment and has impact on the patient’s ability to rehabilitate. Chronically, up to a quarter of TBI cases have cryptogenic dizziness and imbalance, possibly due to chronic brain adaptation that masks the diagnosis. Establishing the spectrum of vestibular diagnoses in acute TBI – when they may be more obvious – may aid diagnosis in chronic TBI cases.Design Prospective audit of referrals to specialist neuro-otology team.Subjects Consecutive Major Trauma Ward TBI in-patients admitted between June 2014 and May 2015.Methods All cases were screened by the therapists for vestibular symptoms and/or signs and referred for specialist neuro-otology review.Results Of 111 patients screened, 96 had features of vestibular dysfunction. Of 96 cases, SYMPTOMS (i.e. subjective report) included: – imbalance (58.3%) – headache (50%) -dizziness (40%) Of 96 cases, SIGNS (i.e. examination) included: – gait ataxia (75.5%) – broken smooth pursuit (61.2%) – positive Hallpike (51%) – positive head impulse test (18%). The data indicate that BPPV affects 49% and headache with migraine-like features affect 40.8%. Acute peripheral unilateral vestibular loss affects 18% TBI cases.Conclusions Vestibular dysfunction in TBI is common, typically involving peripheral and central structures, often in the same case, and requires specialist neuro-otological management.