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Causes of Vertigo & Dizziness

Benign Paroxysmal Positional Vertigo (BPPV)

Benign paroxysmal positional vertigo (BPPV) is a vestibular disorder arising in the inner ear which is caused when a collection of calcium particles bunch in the inner ear canals. Its symptoms are repeated episodes of positional vertigo – a spinning sensation caused by changes in the position of the head. BPPV is the most common cause of the symptoms of vertigo. Assessment and treatment can lead to a complete recovery in one physiotherapy visit for unilateral BPPV. More complex presentation will require follow up treatment.

Vestibulo-ocular reflex (VOR)

Eye movement that functions to stabilize gaze by countering movement of the head. In VOR the semicircular canals of the inner ear measure rotation of the head and provide a signal for the oculomotor nuclei of the brainstem, which innervate the eye muscles. The muscles counter-rotate the eyes in such a way that a rightward head rotation causes an equal leftward rotation of both eyes, with the result that gaze direction stays stationary. Any delay or deficit of the vestibulo-ocular reflex will cause a mismatch within the entire vestibular system and cause a feeling of dizziness, swaying or light headedness. Some patients report the feeling of standing on a ship at sea. Assessment and treatment for a dysfunctional VOR can significantly improve these symptoms.

Neck Proprioception (joint position sense)

Any deficit or delay in proprioception can lead to a mismatch in sensory nerve integration within the vestibular system leading to dizziness and balance issues. Although the integration is quite complex, patients displaying a reduction in cervical proprioception have improved their symptoms with specific exercises designed to retrain the neck proprioceptive system. While treatment effects are not as dramatic as those for BPPV, with time and persistence patients can significantly reduce and sometimes eliminate their persistent dizziness.

Meniere’s Disease

Meniere’s Disease is another common cause of vertigo & dizziness and occurs when there is a buildup of fluid that can have effects on hearing and balance. Some symptoms of Meniere’s Disease include ringing in the ear (Tinnitus), hearing loss, and vertigo and is common in individuals between the ages 40-60 years old. Unfortunately, there is no cure for Meniere’s disease, but symptoms can be improved by adhering to diet changes such as eliminating simple sugars, caffeine and alcohol and reducing salt intake.

MENIERE’S DISEASE
Meniere’s Disease is another common cause of vertigo & dizziness and occurs when there is a buildup of fluid that can have effects on hearing and balance. Some symptoms of Meniere’s Disease include ringing in the ear (Tinnitus), hearing loss, and vertigo and is common in individuals between the ages 40-60 years old. Unfortunately, there is no cure for Meniere’s disease but symptoms can be improved by adhering to diet changes such as eliminating simple sugars, caffeine and alcohol and reducing salt intake.

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