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Dizziness
Published in Henry J. Woodford, Essential Geriatrics, 2022
Vestibular rehabilitation is a form of exercise programme involving movements that induce the vertigo. These movements are taught by a clinician but can then be self-administered at home. They should be performed daily for six to 12 weeks.8 The theory is that this invokes neurological adaptation that lessens the symptom impact. A Cochrane review of vestibular rehabilitation for people with unilateral peripheral vestibular disorders found evidence that it is safe and effective.14
Common otology viva topics
Published in Joseph Manjaly, Peter Kullar, Advanced ENT Training, 2019
Posturography (also referred to as computerised dynamic platform posturography testing) is used to assess the vestibulospinal reflexes, including integration of visual and somatosensory cues. This reflex includes input from the superior SSC and otolithic organs. Various tests are undertaken. They can inform vestibular rehabilitation.
Computational simulation of the vestibular system using a meshless particle method
Published in J. Belinha, R.M. Natal Jorge, J.C. Reis Campos, Mário A.P. Vaz, João Manuel, R.S. Tavares, Biodental Engineering V, 2019
C.F. Santos, Marco Parente, J. Belinha, R.M. Natal Jorge, Fernanda Gentil
The vestibular rehabilitation exercises stimulate the brain to use visual clues and proprioceptive alternatives to keep balance and gait. There are evidence that improve nystagmus, control postural dizziness and all other symptoms vertigo, which makes it the definitive treatment for most patients (Kerrigan, Costigan, Blatt, Mathiason, & Domroese, 2013). The exercises progression is guided by both patient symptoms and related physio-pathological mechanisms.
Dizziness and balance outcomes after two different postoperative rehabilitation approaches following neck surgery: analyses of a multicenter randomized controlled trial
Published in Physiotherapy Theory and Practice, 2023
Anna Hermansen, Ann-Sofi Kammerlind, Johanna Wibault, Håkan Löfgren, Peter Zsigmond, Åsa Dedering, Birgitta Öberg, Anneli Peolsson
Patients in the present study were included due to their arm and neck pain and neurological symptoms of CR (Wibault et al., 2018), and not their dizziness; therefore, one limitation of the present study is that we do not know if causes other than from the neck might be responsible for their dizziness or balance symptoms. Patients with cervical myelopathy were, however, not included in the original study sample which eliminates the impact of, for example, reduced somatosensory reception from the feet on dizziness and balance problems. Eye movements in all movement planes were performed as part of the initial exercises to activate the deep cervical muscles (Wibault et al., 2018); however, no further specialized sensorimotor exercises were included in the rehabilitation program. Complementary vestibular rehabilitation exercises were recommended for individuals with dizziness or balance problems at baseline. A limitation of this study was the lack of registration of participants in the intervention group who received these complementary exercises. Sensorimotor exercises, together with local treatments aimed to reduce neck pain and restore function, and vestibular rehabilitation, have been recommended to treat cervicogenic dizziness (Treleaven, 2008). In future studies, it would be interesting to evaluate the effect of a rehabilitation program specifically combining these three exercise types on patients who presented with remaining dizziness and balance problems after neck surgery due to cervical radiculopathy.
Relationships between the Pittsburgh Sleep Quality Index (PSQI) and vertigo outcome
Published in Neurological Research, 2023
Zhihui Du, Guoliang Wang, Dan Yan, Fang Yang, Dan Bing
The treatment for vertigo or dizziness and underlying diseases were based upon the recommendation from consensus documents and guidelines [16,26,27]. The most common primary diagnosis in this study is VM, and the second most common is MD. We used flunarizine hydrochloride and Tianshu capsule as the first-line medication for VM. Though not mention in the guideline, Tianshu capsule has a very long history in China in prophylactic treatment of headache and shows better compliance [28], For MD and DEH patients, betahistine is the treatment of choice. VP patients were prescribed with carbamazepine as the first option. Vestibular rehabilitation exercises were introduced to patients in addition to medical treatment or as stand-alone treatment option, if no contraindications existed [29].
Roll maneuvers versus side-lying maneuvers for geotropic horizontal canal BPPV: a systematic review
Published in Physical Therapy Reviews, 2021
Bonni Lynn Kinne, Mikaela Grace Harless, Kyra Ann Lauzon, Jill Renee Wamhoff
As mentioned in the introduction, horizontal canal BPPV tends to spontaneously resolve in a relatively short period of time secondary to the anatomical positioning of the semicircular canals [5, 7, 8]. Some researchers have discovered that the resolution rate of horizontal canal BPPV in untreated individuals may be as high as 53 percent [37] to 69 percent [24] in one week and that only 7 percent [24] to 11 percent [37] of these individuals will continue to experience their vertigo for longer than one month. Other researchers have found that the average time from the onset to the resolution of horizontal canal BPPV symptoms in untreated individuals is 4.9 +/- 5.3 days [38] to 16 +/- 19 days [37]. However, two studies included in this systematic review reported that 40 percent [27] to 52 percent [21] of untreated individuals with horizontal canal BPPV continued to experience their vertigo one month after its onset. In addition, some of the participants in two of the included studies [23, 31] began vestibular rehabilitation several years after their symptoms began. This revelation is problematic because the vertigo associated with horizontal canal BPPV is usually much more intense than that associated with posterior canal BPPV [5, 7, 8]. In addition, horizontal canal BPPV often adversely affects dynamic balance [10]. Therefore, the maneuvers described in this systematic review may expedite the natural remission process in individuals with long-term symptoms associated with horizontal canal BPPV.