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EQUILIBRIUM
Equilibrium or orientation in space is maintained by the visual, kinesthetic, and vestibular mechanisms.Vertigo, or vestibular dysequilibrium, is a sense movement that is perceived by the patient as “subjective,” in the case of movement of self, or as “objective,” in the case of movement of the environment.
The movements may be described as a sense of spinning, pulsion, or tilting of the visual environment with change of head position.
This section is primarily concerned with permanent impairment resulting from defects of the vestibular (labyrinthine) mechanisms and its central connec tions. The defects are evidenced by loss of equilibrium produced by:
(1) loss of vestibular function; or
(2) disturbances of vestibular function. (Light-headedness and abnormalities of gait not associated with vertigo are not considered.)
Class 1 Impairment of the Whole Person, 0% A patient belongs in Class 1 when
(a) signs of vestibular dysequilibrium are present without supporting objective findings (e.g., nystagmus, ataxia); and
(b) the usual activities of daily living can be performed without assistance.
Class 2 Impairment of the Whole Person, 5—10% A patient belongs in Class 2 when
(a) signs of vestibular dysequilibrium are present with supporting objective findings (e.g., nystagmus, ataxia); and
(b) the usual activities of daily living are performed without assistance, except for complex activities such as bike riding, or certain activities related to the patient’s work, such as walking on girders or scaffolds.
Class 3 impairment of the Whole Person, 11—30%
A patient belongs in Class 3 when
(a) signs of vestibular dysequilibrium are present with supportive objective findings (e.g., nystagmus, ataxia); and
(b) the patient’s usual activities of daily living cannot be performed without assistance, except such simple activities as self care, some household duties, walking on the street, and riding in a motor vehicle operated by another person.
Class 4 impairment of the the Whole Person, 31—60% A patient belongs in Class 4 when
(a) signs of vestibular dysequilibrium are present with supportive objective findings (e.g., nystagmus, ataxia); and
(b) usual activities of daily living cannot be performed without assistance, except for self care.
Class 5 Impairment of the Whole person, 61 —95% A patient belongs in Class 5 when
(a) signs of vestibular dysequilibrium are present with supportive objective findings (e.g., nystagmus, ataxia); and
(b) the usual activities of daily living cannot be performed without assistance, except self-care not requiring ambulation; and
(c) confinement to the home or premises is necessary.
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