Vestibular Disorders Dizziness

Vestibular Disorders & Dizziness

The vestibular system is the body’s own ‘spirit level’ and gives our brain the ability to perceive information related to where we are in space and where gravity field is. This allows us to maintain balance. The system involves the inner ear (known as the vestibular apparatus) and links up the antigravity muscles and the visual information that is processed together by our brain. When parts of this system are damaged, we can feel dizziness, vertigo, lightheaded or off balanced.

Vestibular disorders are often misdiagnosed and under-treated. This is because they share lots of overlapping symptoms, which can be difficult to analyse where there may be multiple contributing factors. They can also share symptoms with other conditions such as stroke and head or neck injury. This includes, but are not limited to:

  • Labrynthitis and vestibular neuritis

  • Benign paroxsmal positional vertigo (BPPV)

  • Meniere's diease

  • Perilymph fistula

  • Secondary endolymphatic hydrops

  • Acoustic neuroma

  • Enlarged vestibular aquaduct syndrome

  • Mal de Barquement syndrome

Common challenges:

  • Illusion that you are moving

  • Dizziness

  • Vertigo

  • Drifting to one side

  • Feeling like you are rocking on a boat

  • Headache

  • Light sensitivity

  • Noise sensitivity

  • Lightedness

  • Neck or jaw pain

  • Anxiety and depression

The role of a neurological physiotherapist in vestibular disorders:

Neurological physiotherapists are physiotherapists with additional training and expertise in treating problems related to the brain, spinal cord, inner ear and nerves. Many of our therapists have undergone additional postgraduate training in the assessment and treatment of vestibular disorders. Some conditions can be diagnosed and managed by neurological physiotherapists alone while others will require further testing from neurologists or ENT specialists.

Even a mild to moderate levels of dizziness can be hugely debilitating. Research has shown that many types of vestibular conditions benefit from vestibular rehabilitation.

What our skilled therapists can offer:

Our therapists can perform clinical tests to help guide you towards a diagnosis. These include:

  • Observation of the static eye

  • Observation of the facial muscles

  • Observation of the eye when tracking a slow moving object

  • Observation of the eye when tracking a fast moving object

  • Vestibular ocular reflex (VOR) testing

  • Head thrust test

  • Dynamic visual acuity test

  • Movement and positional testing

  • Balance and walking assessments

  • Examination of the neck, sensory systems, range of motion and coordination as needed

Some tests are more specific than others, but they all help form the clinical picture of the individual’s problem from an anatomical to a functional level. For the majority of cases, these assessments will be enough to formulate a working diagnosis.

With this thorough assessment and clinical reasoning, some cases of vestibular dysfunction can be treated conservatively and effectively within a few sessions. Once the underlying problem has been treated, home exercises can be done to control symptoms and improve balance in a graded manner so you return to your usual way of life.

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