Dizziness is one of the most common complaints that patients see their doctors for. There are many different causes and can therefore sometimes be difficult to diagnose. Symptoms can be vague, for instance, feeling lightheaded or disorientated or more clear cut symptoms of vertigo or spinning and feeling off-balance. The most common cause of vertigo is BPPV (Benign Paroxysmal Positional Vertigo) which can be treated using the Epley Manouevre. The other causes of dizziness include:
- Migrainous Vertigo (Vestibular Migraine)
- Vestibular Neuronitis / Labyrinthitis
- Meniere’s Disease
- Acoustic Neuroma
- Following a stroke or after a head injury
- Certain drugs
- A stiff and painful neck (Cervicogenic Dizziness)
- Neurological conditions such as Multiple Sclerosis
- Ageing affecting the Balance System
Vestibular rehabilitation is an exercise-based programme which is designed to help the brain compensate following an episode of vertigo or dizzy spells. The physiotherapist will take a comprehensive history and assessment of eye movements and balance tests. Depending on the assessment findings, three methods of exercise can be prescribed.
Habituation exercises are more appropriate for patients reporting dizziness when in visually stimulating places such as busy shopping areas, walking over patterned flooring or even watching action films or scrolling on computers. Over time with the exercises, the dizziness improves as the brain learns to ignore some of these abnormal signals.
Gaze stabilisation exercises are given to patients who report their visual world jumping or bouncing such as when reading or when they are moving around. These exercises improve the control of eye movements with head movements.
Balance retraining exercises improve patient’s ability to walk outdoors, walk in the dark and feel more secure on uneven ground. These exercises are designed to be challenging but patients should feel safe.
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