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Dizzy? Vestibular Therapy May Help - April 5, 2013

Dizzy? Vestibular Therapy May Help

By: Amy deBuhr, PT, CBIS

  • The term "vertigo" refers to the sensation that either you, or your environment, is rotating. The sensation of vertigo is most often associated with a problem in the vestibular system.

  • Your vestibular system is made up of your eyes and your inner ears. The most important thing your vestibular system does is allow your eyes to focus on an object while your head is moving. When your eyes and your inner ears don't work together, symptoms may include vertigo, dizziness, nausea, and balance problems.
  • THe prevalence of brian injury survivors who have post-traumatic vertigo is difficult to determine. Research indicates that it is likely somewhere in the neighborhood of 20%. 

The most common diagnosis associated with post-traumatic vertigo is benign paroxysmal positional vertigo (BPPV). The culprits are the rocks in your head. Okay...they're not actually rocks, but rather small calcium carbonate crystals that reside in your inner ear and give you information about gravity, balance, movement, and direction. When there is an injury to the head, it is not uncommon for these crystals to become dislodged and settle in another area of the inner ear, causing vertigo.

Other, less common causes for post-traumatic vertigo, include post-traumatic Meniere's Syndrome (episodes of dizziness accompanied by noises in the ear, fullness, or hearing changes), labyrinthine concussion (non-persistent hearing loss following TBI), and vertigo caused by a fracture in the temporal bone, where the inner ear is housed.

Fortunately, there are specific assessment and treatment strategies that can, in some cases, provide nearly immediate relief of vertigo symptoms. BPPV specifically can be easily assessed with positional testing and treatment. Habituation exercises are often taught following treatment and clearing of BPPV to reduce the possibility of recurrence. In some cases, medications can be prescribed by your doctor to reduce vertigo. Stephanie's article details many of the vision challenges taht complicate the assessment and treatment of vestibular dysfunction. However, vestibular rehabilitation of BPPV can be easy often clearing within one to two sessions with education of exercises. In the grand scheme of rehabilitation following TBI, vestibular rehab can often eliminate one major barrier to independence allowing for improved quality of life. Feel free to contact me at if you have questions about vestibular therapy in our outpatient program.