|
Vestibular (Dizziness) and Balance Rehabilitation |
|
Frequently Asked Questions |
|
Vertigo is a specific type of dizziness that makes
people feel like they are suddenly spinning, whirling,
or falling while they are not actually moving.
Patients have described this sensation as being "on a
rollercoaster all of a sudden." People with Vertigo
feel like they have "motion sickness" and usually have
nausea, vomiting, and hearing loss. The treatment
depends upon the cause of the Vertigo. There are many
different causes and types of Vertigo. |
|
Vertigo can be caused by problems with the brain and central
nervous system, the inner ear, or both. The problems
within the ear are referred to as peripheral
vestibular disorders. These include:
-
BPPV or benign paroxysmal positional Vertigo
-
Labyrinthitis
-
Menieres disease
-
Ototoxicity (ear poisoning)
-
Inner ear degeneration - seen in the elderly
-
Infection leading to Vestibular neuritis
-
Medications
-
Long term use of antibiotics
|
|
The problems within the brain or nervous system are referred
to as Central Vestibular disorders. These include: |
-
Cardiovascular or heart problems
-
Head trauma or ear injury
-
Migraines
-
MS or Parkinson's Disease
-
Tumors (acoustic neuroma)
-
Orthostatic hypotension (sudden low blood pressure)
|
|
The National Institute of Health reports that as many
as 40% of adults in the United States experience
Vertigo at least once during their life. The chance
of Vertigo increases with age and appears more
frequently in women. |
|
There are three basic types of Vertigo. The most
common type is positional Vertigo. Positional
Vertigo
occurs with specific head movements or motions. For
example, Vertigo can occur while you are getting your
hair washed at the salon or when you are lying down
and change positions (i.e.
moving from your back to your side). These are
associated with peripheral vestibular (inner ear)
problems. The two other types are spontaneous and
recurrent Vertigo. These are usually the result of
central (brain) vestibular disorders and can occur at
any time and in any position. |
|
Vertigo is usually treated by your medical doctor, or
specialist including an ear, nose and throat
specialist for peripheral vestibular (ear) or a
neurologist for central (brain) vestibular disorders.
Your doctor or specialist will provide a series of
specialized tests to help determine the cause. The
initial treatment is medications which can help
control the spinning (vestibular suppressants),
antiemetics drugs to control the nausea, and
anticholinergics to help increase motion tolerance.
In severe rare cases, surgery is an option. In many
cases the doctor will refer the patient to physical
therapy for Vestibular Rehabilitation. Physical
Therapy has been shown to be the most effective
treatment for BPPV, as well as for patients with
unilateral vestibular losses due to neuritis and
injury. |
|
Vestibular rehabilitation or balance rehabilitation is
an exercise based approach to the dizziness or
spinning symptoms and disequilibrium associated with
central (brain) or peripheral (ear) vestibular
pathology. While many patients get relief from their
symptoms from the medications, some individuals cannot
tolerate the medication or do not like the side
effects. These side effects can make people feel
"woozy" or "sedated" and can limit function. Balance
and vestibular rehabilitation is an alternative form
of treatment involving specific exercises which will
help to increase general activity and conditioning
levels, increase balance, and decrease dizziness.
These programs help the central nervous system
compensate for the deficits and in most cases of BPPV,
actually correct the problem. |
|
Benign Paroxysmal Positional Vertigo is a specific
type of Vertigo that is believed to be caused by small
calcium carbonate crystals or debris which has
collected in the inner ear. These crystals or
"Otoconia" tend to build up and can effect the
function of the ear. Inner
ear degeneration, head injury, or inner ear infection
can also cause BPPV. In general, the older you are the
more likely your Vertigo is caused by BPPV. It is
believed that 50% of all dizziness in older people is
due to BPPV. A typical example is a patient who feels
fine, then gets a terrible spinning sensation while
getting her hair washed at the beauty parlor. |
|
Your doctor or specialist will be the person to diagnose your
condition after a battery of tests. If the doctor
determines you have BPPV or another type of treatable
Vertigo, they will refer you for vestibular and
balance rehabilitation.
BPPV can be diagnosed using the Dix-Hallpike
maneuver. This simple test will help diagnose
positional Vertigo and help determine which ear is
most affected. This test can be done by most health
care professionals. After initial diagnosis, your
physician or specialist may order a battery of more
specific tests to further diagnose your condition. |
|
All patients will be given a generalized balance retraining
program. These exercises will help improve the
coordination between the body's sensory and balance
centers. Adaptive and compensatory strategies are
discussed to help the patient to habituate or get used
to the positions that cause the Vertigo. All patients
will be given a home exercise program (Cawthorne
Cooksey) to help strengthen or improve the vestibular
system.
The BPPV treatments involve a series of maneuvers and
procedures that help to remove the debris from the ear
and eliminate the Vertigo symptoms. These include the Epley's, Sermont and Brandt-Daroff maneuvers which
will help free up the debris (Otoconia) from the ear canals. |
|
Recent studies have shown that the treatments for BPPV
are very effective. One 1993 study showed an 80%
of patients treated with these procedures for BPPV
improved.
BPPV will often reoccur. A recent study in 2001
showed that about 1/2 of all patients who had BPPV
suffered a recurrence. Almost 1/3 of the
reoccurrences happened within the first year. In case
of reoccurrence, Physical Therapy would continue with
the procedures and exercises until a positive outcome
is obtained once again. |
|
You will meet and be evaluated by our medical team who
has received specialized training in Vestibular
Rehabilitation. After your assessment, the Physical
Therapist and our medical team will help determine an
individualized plan of care and with your permission begin treatment
immediately. As the treatments may cause symptoms, it
is always best to have someone drive you to the
initial session. Anti-nausea medication would also be
recommended prior to treatments, if nausea is a
problem. |
|
Call Allied Medical & Rehabilitation, P.C. today. We
have an excellent Vestibular & Balance protocol that
is highly effective and will help to decrease your
Vertigo and increase your balance. |
|
|
|
|
