Therapro | Specialized Programs


	Overview
	Symptoms
	Dizziness Disorders
	Various Testings
	Getting help

You no longer have to feel like you are "spinning" out of control.

Overview

If you are an older person with a balance problem, you've likely been told that poor balance is a natural and untreatable part of getting older! Or worse, whether younger or older, you've been told that your "dizzy spells" are all in your head!

The good news is that medical research has proven that balance problems are NOT imaginary or inevitable with age, and there are effective treatments available for those who do experience balance problems or dizziness.

There are three main components that maintain your sense of balance.

Somatosensory system. A fancy term for your sense of touch.
Visual System.
Vestibular system. This refers to your equilibrium within your inner ear.

In order to maintain proper balance your brain must process all three systems accurately. In a normal healthy individual our senses of touch (feet, ankles, and joints), sight (eyes) and inner ear motion sensors work together in harmony with the brain. A person with a balance disorder, however, may have a problem in any one of these systems, or in multiple systems. In some individuals, one or more of the senses are missing and the person does not realize they are losing their balance. In other people, the brain gets confused and creates an inaccurate sense of falling when in fact the person is in balance. The risk of developing one or more of these problems increases with age as our senses or brain centers are exposed to degenerative or infectious diseases, or the effects of injuries accumulated over a lifetime.

Symptoms

The dizziness, lightheadedness, unsteadiness or vertigo sensations you may feel are very real. Specific causes can be identified with an appropriate medical evaluation and tests conducted by a qualified clinician. The great news is that, once identified, most dizziness disorders can be successfully treated.

Dizziness Disorders

Dizziness is a broad term used to explain how we feel when our sense of balance is not quite right. The term encompasses a variety of sensations that can mean different things to different people. If you have ever been dizzy, you may have found it difficult to describe exactly how it made you feel. Some people who report feeling dizzy say they feel as if everything is spinning around them, or as if they are spinning or turning themselves. This is what doctors usually mean when they refer to vertigo. Others describe feeling wobbly or unsteady as if they were on a boat. And still others may describe their dizziness as a feeling of "floating", lightheadedness or "giddiness". Dizziness or vertigo can be caused by a disturbance in a particular part of the inner ear - the vestibular system. This is the part of your balance system that provides your brain with information about changes in head movement with respect to the pull of gravity. When your vestibular system is not working properly, the result may be dizziness, vertigo, imbalance, disorientation and possibly nausea and vomiting. Some specific disorders known to cause dizziness and/or vertigo are listed in alphabetical order:

	-	Acoustic neuroma is loosely defined as a tumor on the nerve from the inner ear to the brain. Patients with this disorder may experience a gradual hearing loss, ringing or buzzing in the ears and dizziness. A sensation of pressure and fullness may also be present.

	-	Arteriosclerosis, a hardening or narrowing of blood vessels that supply blood to the brain, may cause decreased blood flow, resulting in dizziness.

	-	Benign Paroxysmal Positional Vertigo (BPPV) is a balance and dizziness disorder caused by a problem in the vestibular system of the inner ear which forms part of the balance organs. Small particles or crystals become detached from their normal location in the inner ear and interfere with the normal function of the vesular system. As the name indicates, the vertigo, which can be intense, comes on suddenly following certain movements of the head. This type of vertigo comes and goes and, if left untreated, may be recur for years.

	-	"Central" or neurological vertigo refers to dizziness that results from problems in the balance centers of the brain, rather than the ear. This type of dizziness is generally much less common than dizziness caused by inner ear problems. Strokes, multiple sclerosis, brain tumors or cysts and deformities of the upper spine or the back of the brain are all possible causes.

	-	Hyperventilation can cause temporary dizziness and sometimes occurs when you are exercising strenuously or if you hold your breath when you are under stress.

	-	Labyrinthitis is an inflammation, usually caused by a virus, of the labyrinth, the part of the inner ear that contains the organs of balance.

	-	Meniere's disease is a condition in which repetitive attacks of vertigo are accompanied by pressure in the ears, buzzing or ringing, and partial hearing loss that can fluctuate during an episode.

	-	Ototoxicity is caused by exposure to, or ingestion of a particular substance which damages the auditory and inner ear system. Ototoxicity may result in irreversible damage to hair cells in the inner ear and/or vestibular system, which may cause vertigo, vision problems, hearing loss, gait unsteadiness and imbalance.

	-	Osteoarthritis, a joint disease, can affect the neck or cervical area of the spine. Openings in the neck vertebrae contain arteries, which supply the brain with blood. When these openings narrow as a result of osteoarthritis, blood flow to the brain is restricted, resulting in dizziness.

	-	Peripheral vestibular disorders refers to all forms of dizziness caused by inner ear problems, including BPPV, labyrinthitis and Meniere's disease. The term is commonly used when a doctor knows the problem is in the inner ear, but is unable to be more specific.

	-	Post-traumatic vertigo is dizziness resulting from a head injury, concussion or whiplash.

	-	Tinnitus is buzzing or ringing in the ears and can occur with dizziness or may be a symptom by itself.

	-	Viral labyrinthitis is a viral inflammation of the inner ear. It causes dizziness/vertigo which may last days or weeks, usually following a cold or flu.

	-	Vascular vertigo is dizziness caused by problems with the blood supply to the inner ear or the balance centers of the brain. This can occur in people who suffer from migraine or those who are overweight, smoke, have high blood pressure or don't get enough exercise.

	-	Vestibular neuronitis is an infection of the vestibular nerve, generally viral.

	-	Postural hypotension is indicated by symptoms of lightheadedness or blackouts, and is typically experienced when rising from a lying or sitting position.

Various Testing

To determine the cause of a balance problem, you will first be asked to describe your problems and symptoms. You will most likely fill out a problem focused questionnaire. The results of the questionnaire will be combined with a physical examination. Based on this information, your doctor will develop a working diagnosis. Depending on what he or she determines, your doctor may then order tests designed to confirm the diagnosis. The test results also determine how key components of your balance systems are functioning. Depending on the suspected type of balance abnormality a battery of tests may be ordered. The most common of which is an ENG (Electronystagmography). This is actually a series of painless procedures designed to pinpoint the source of your problem.

Nystagmography Tests: This is a series of tests designed to document your ability to follow visual objects with your eyes and how your eyes respond to some types of information from your vestibular system. To monitor the movements of your eyes, your doctor may place electrodes around your eyes (electronystagmography-ENG) or may use an infrared video camera (IR video nystagmography). Eye movement tests are useful, because some patients with balance system problems have problems seeing clearly when moving, or they get the erroneous sense that objects are moving.

Occular Movility: You will be asked to follow with your eyes objects that jump from place to place or move smoothly. Your doctor will be looking for any slowness or inaccuracies in your ability to follow visual targets.
Optokinetc Nystagmus: You will be asked to view a large, continuously moving visual image to see if your eyes can appropriately track these movements.
Positional Nystagmus: Your doctor will move your head and body into various positions to make sure that there are no inappropriate movements of your eyes when your head is in different positions.
Caloric Test: Your doctor will stimulate both of your inner ears (usually one at a time) with warm and then cold air. He or she will be monitoring the movements of your eyes to make sure that both your ears can sense this stimulation.

Balance can be improved!

There are many people who have had symptoms just like you who have experienced relief through therapy. It is not uncommon for individuals with a history of balance problems to regain their balance control through accurate diagnosis followed by specific medical treatment and/or rehabilitation exercises. One famous example is astronaut John Glenn. Following his historic space flights in the 1960's, Glenn experienced balance problems that disqualified him from service. After a rehabilitation program, Glenn was able to return to space at the age of 77 and he performed as well as his younger colleagues. You can recover from balance disorders and regain your control. And you can do this even at an advanced age!

Effective treatment is available!

Ask Your Doctor How THERAPRO can help!