Vestibular Balance Dizziness Treatment

Vestibular Assessment

Balance is the result of a number of body systems working together; the eyes (visual system), ears (vestibular system) and the body's sense of where it is in space (proprioception) ideally need to be intact.

When the sense of balance is interrupted it causes unsteadiness. Symptoms that accompany the unsteadiness can include dizziness, vertigo, hearing and vision problems and difficulty with concentration and memory etc.

Here in our clinic, we do a detailed evaluation of vestibular system (peripheral and central) to rule out the site of lesion and thus accurately defining the vestibular rehabilitation.

Vestibular Testing

The primary organ of balance in the human body is situated in the inner ear. If for any reason there is an abnormal increase or decrease in the signal being delivered to the brain, it percieves it differently and this is termed as dizziness or vertigo. Infections, illness, disease, head trauma and natural ageing process may cause disturbance in equilibrium.

Balance-related falls account for 300,000 hip fractures and 50 percent of accidental deaths for those over age 65. Ninety percent of all causes of dizziness can be identified after a thorough medical evaluation, however, if left improperly diagnosed or untreated, problems can linger for years. Most balance problems can be treated medically, surgically or with vestibular rehabilitation.

Proven protocols for diagnosis, treatment and rehabilitation
To achieve a true differential diagnosis and recommend the most clinically appropriate treatment, the Institute employs proven methodologies and protocols that combine to provide medicine’s most comprehensive evaluation and treatment.

Comprehensive Diagnostic Audiological Evaluation
Includes video otoscopy, tympanometry, acoustic reflexes with ipsilateral and contralateral stimulation, otoacoustic emissions (OAEs), pure tone audiometry, speech recognition thresholds, and word recognition thresholds.

Vestibular Evoked Myogenic Potential (VEMP)
When sound stimulates the saccule, a response travels through the inferior vestibular nerve to the vestibular nucleus in the brainstem. Neural impulses are then relayed through the vestibulospinal tract to the neck muscles. This test provides critical information regarding the integrity of the saccule and inferior vestibular nerve.

Videonystagmography (VNG)
The VNG is a three-part evaluation that assesses the inner ear and central functions of the motor system. First is the oculomotor exam which assesses the patient’s eye movements as they follow a moving target. The second part tests the patient’s response to various head positions. Finally, the caloric test independently evaluates the horizontal semicircular canals and the vestibular nerves

Video - Head Impulse Test (VHIT):
The only test that can assess all six semicircular canals. The vHIT measures the patient’s vestibulo-ocular reflex (VOR) in response to head movement. Itenables head impulse testing with gold-standard accuracy.

Which patients benefit most from our specialized treatment and care?
Patients with acute, chronic, undiagnosed or unexplained dizziness and balance complaints make excellent candidates for an Institute referral. Those who have undergone normal electronystagmography (ENG) or videonystagmography (VNG) without conclusive results may also benefit, as well as those with:
Vertigo or dizziness that is unresponsive to traditional medical management

Vestibular Rehabilitation Therapy helps return patients to normal activities One treatment that has been consistently proven effective in treating the underlying medical cause of balance and dizziness-related falls is Vestibular Rehabilitation Therapy or VRT.

Balance and VRT:
Teaching the brain to correct itself. VRT is a highly effective, customized therapeutic approach for treating patients with vestibular balance system disorders. Studies show that individualized VRT is significantly more effective in resolving symptoms than commonplace treatments, such as medication or general balance exercises.

The Institute’s VRT is designed as a clinicdirected therapy approach, using congruent homebased exercises that are patient motivated. Patients typically visit the clinic once or twice a week for up to six weeks or until their stability returns.

Our VRT exercise protocols take full advantage of the brain’s natural plasticity and ability to restore symmetry and increase sensitivity. The goal is to improve patients’ overall stability and motor control by enhancing the vestibulo-ocular reflex (VOR) – a reflexive eye movement that stabilizes images on the retina during head movement. Successful VRT returns patients to maximum activity levels as quickly and comfortably as possible