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The Vestibular Disorders Association estimates that 42% of the adult population reports episodes of dizziness or vertigo to their physicians and that I 85% of those cases vestibular dysfunction causes the patient’s problems.  The vestibular system includes the parts of the inner ear and brain that process the sensory information involved with controlling balance and eye movements.  If disease or injury damages these processing area, vestibular disorders can result.  Vestibular disorders can also result from or be worsened by genetic or environmental conditions, or occur for unknown reasons.

What Are The Symptoms of a Vestibular Disorder?

The vestibular system includes the parts of the inner ear and brain that help control balance and eye movements.  If the system is damaged by disease, again, or injury, vestibular disorders can result, and are often associated with one or more of these symptoms, among others:

  •  Vertigo and dizziness
  •  Imbalance and spatial disorientation
  •  Vision disturbance
  • Hearing changes
  • Cognitive and/or psychological changes
  •  Other symptoms

Every person with an inner ear disorder will not experience all symptoms, and other symptoms are possible.

Left unaddressed, the occasional dizziness or disequilibrium can lead to fall injuries, auto accidents, work accidents, or fear of performing normal activities daily living.

Benign paroxysmal positional vertigo (BPPV) has been described as the most prevalent form of vertigo, with incidence rates estimated as high as 50% in the age 70+ population.

Impressive Results:  Numerous studies have demonstrated the efficacy of physical therapy approaches for BPPV.  Noteworthy among these studies for the large number of patients treated is the work of Gans and Harrington-Gans, which followed 376 patients with confirmed diagnoses of BPPV posterior canal.  Seventy-nine percent of their patient’s required only one treatment and 17% required two treatments.  Between 207% experienced recurrence.  Most other Investigator’s using similar diagnostic criteria similarly report success rates greater than 90%.BPPV can be treated with a modified Canalith Repositioning Maneuver and/or a Semont Liberatory Maneuver.  The head repositioning techniques work to mobilize debris in the posterior canal so that it can return to the utricle and dissolve.Vertebral compression of the artery contraindicates some maneuvers in vestibular rehabilitation. Patients should be pre-screen with a Vertebral Artery Test.  When tested positive, a report is sent to the referring practitioner and the patient should avoid neck hyperextension positions.  Patients should also be screened for orthopedic and neurologic conditions that may contraindicate evaluation or treatment.  Complications from BPPV repositioning maneuvers occur rarely but include horizontal canal migration and Canalith jam.  Additional repositioning maneuvers can correct both of these complications.

By Sohaila Mosaddegh PT, DPT, CEO

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