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Vertigo

IntroductionWake Forest Physical Therapy Balance and Vestibular

Vertigo is a feeling that you or your surroundings are moving when there is no actual movement.  You may feel as though you are spinning, tilting, or falling.  When you have severe vertigo, you may feel very nauseated or vomit.  Vertigo can cause trouble when walking or standing, and you may lose your balance and fall.

Anatomy

The inner ear contains the semi-circular canals, which also contain fluid and hair cells. The hair cells in the semi-circular canals sense the position of the body and send this information to the brain.  This structure allows the body to maintain balance and equilibrium.

Causes

Common causes of vertigo include inner ear disorders, such as benign paroxysmal positional vertigo (BPPV), Meniere’s disease, vestibular neuritis, or labyrinthitis, injury to the ear or head, migraine headaches, and decreased blood flow through the arteries that supply blood to the base of the brain.  Some other less common causes of vertigo include a noncancerous growth in the space behind the eardrum, or brain tumors and cancer that has traveled from another part of the body.

Symptoms

A bout of vertigo can last from a few minutes to several days, and sometimes much longer.  Some of the symptoms that you may experience are a sensation that everything around you is moving or spinning, loss of balance, nausea, vomiting, light-headedness, problems walking properly, problems standing still properly, blurred vision, or earache.

Diagnosis

In order to correctly diagnose vertigo, your physician will need to do a series of tests to determine the cause of your dizziness.  He or she will look for signs and symptoms of dizziness that are prompted by eye or head movements and then decrease in less than one movement.  The physician will also look for involuntary movements of your eyes from side to side, as well as the inability to control your eye movements.  There are other diagnostic tests that can be done to rule out other potential causes of dizziness, such as an MRI.

Treatment

Based on your physical therapist’s evaluation and your goals for recovery, the therapist will customize a treatment plan for you.  The specific treatments will depend on the cause of your vertigo.  Your therapist’s main focus is to help you get moving again and manage the vertigo at the same time.  Treatment may include specialized head and neck movements or other exercises to help eliminate your symptoms.  Your PT will also show you exercises to improve your balance, exercises to help the brain correct differences between your inner ears, and exercises to improve your ability to focus your eyes and vision.  Conditions such as benign paroxysmal positional vertigo have very specific tests and treatments.  If you have dizziness and balance problems after your vertigo has stopped, your physical therapist can develop a treatment plan that targets those problems and teach you strategies to help you cope with your symptoms.

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