VERTIGO

The Vestibular System:
Our ability to maintain balance is achieved through the sensory input of a few systems working together in our body. Our vestibular system along with information from our muscles and joints (proprioception) and our visual system provide sensory input. Sensory input is integrated by the cerebellum and the cerebral cortex which then leads to motor output signals determining the response of our body, coordinated balance. An issue in this pathway can lead to the symptoms of dizziness, vertigo, nausea, impaired balance, visual problems and fatigue.

Symptoms of a Vestibular Disorder:
-Vertigo or dizziness
-Nausea
-Visual or Hearing issues
-Impaired Balance
-Nausea
-Difficulties concentrating or fatigue

Vestibular Rehabilitation:
Vestibular rehabilitation is an exercise program designed for you to help your body compensate for vestibular problems. This approach can be used for a number of vestibular disorders like benign paroxysmal positional vertigo and decreased vestibular function due to neuritis or labyrinthitis. A physiotherapist will perform an assessment and determine the exercises that will benefit you the most. It is important to know that these re-training exercises may make you feel worse at the beginning, but it is important to persevere as most often balance begins to improve and symptoms decrease or disappear.

Most Common Form of Dizziness: Benign Paroxysmal Positional Vertigo:
There are many types of dizziness; vertigo is the sensation that the room is moving around you. Benign paroxysmal positional vertigo (BPPV) is the most common form of vertigo. Up to 30% of dizziness in people over 60 is due to BPPV.

Symptoms usually occur with changes in head position, i.e. looking up or rolling in bed. BPPV often comes on with no apparent cause. The vertigo usually lasts a minute or less and goes away if you remain in that position. You may also find that you are nauseous or that you feel unbalanced.

The cause of BPPV has to do with the vestibular system. This is a group of sensory organs in your inner ear that gives your brain information as to where your head is relative to gravity. Within the semi-circular canals of the inner ear there are crystals that may become displaced from their normal location. It is when these crystals migrate to another position that the vertigo sensation occurs.

BPPV can be assessed and treated by a trained physiotherapist using a few tests and specific maneuvers. If diagnosed with BPPV the Epley maneuver can be very effective with most people only requiring one or two treatments. Exercises may be given to do at home as well. If vertigo or dizziness is affecting you, call the clinic to get an assessment.

Lisa Goodgrove
M.Sc.P.T.
Physiotherapist