Ask an Expert Q&A's
Some of BC Balance and Dizziness's most popular meetings include question and answer sessions facilitated by health professionals who are particularly knowledgeable about balance and dizziness issues. On this page, browse a selection of our questions and answers. Want to submit a question to our experts? Click here! (Please make sure you check this Q&A page for answers before submitting a question. We might have already covered your question!)
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My wife was operated on to alleviate bleeding in her brain after a stroke. She now cannot stand up due to dizziness. Where should she go to get diagnosed and what kind of therapy should she undergo?
It sounds as though the stroke was the hemorrhagic type, which is why she needed surgery. Strokes affecting the back of the head can have vertigo as their main symptom and this is likely what happened to your wife. This vertigo is very unlikely related to an inner ear problem. At this point, having a vestibular or inner ear assessment is not recommended. The focus should be on her recovery from surgery. As she recovers and feels able to start moving, sitting up and so on, there should be a physiotherapy team at the hospital that can help her in regaining function. Then, after discharge, a more formal rehabilitation process can begin with physiotherapy.
We’re still not sure of the process by which motion sickness happens. Drugs for this condition have not changed for 60 years. The believed mechanism is a conflict of information between the inner balance sensors, visual, and proprioceptive systems. Those who suffer from motion sickness tend to rely predominantly on their visual system for balance. If you can’t see where you are going, for example while seated in the back seat of a moving car, your motion sickness gets triggered. If you drive, you see where you’re going and feel fine.
For similar reasons, watching things move can also be a major trigger. The brain wants stable vision. Watching moving objects causes problems for some. Examples include crowded situations, action movies, and scrolling computer screens. In these circumstances, the brain has no stable frame of reference. It becomes confused, resulting in nausea and/or dizziness.
We can help the brain by fixing our eyes on a stable object. In a crowd, try to focus on something that isn’t moving. If in a moving car, try to concentrate on a distant stationary object. Nearby objects that are rapidly moving will confuse the brain. Flashes of light or a pattern of light and shadow also trigger motion sickness.
Vestibular Rehabilitation Exercises
Some of the vestibular rehabilitation activities done under supervision are taught to clients to practice at home in a safe and controlled manner. These activities include:
- motion-sensitivity exercises such as rolling in bed, sitting to standing, and walking while turning the head
- many different balance exercises
- visual or gaze exercises
- “target shooting,” that is keeping the head still while moving the eyes, or moving the head and keeping the eyes still
- the Epley maneuver to re-position ear crystals
A treatment for visually-stimulated vertigo consists of watching things in motion. Audiologist Erica Zaia suggests repeatedly watching full-screen versions of the NED Leader (right and left) video clips on YouTube. When you get the feeling that you want to look away, watch for three to five seconds longer. Becoming accustomed to doing the tai chi “cloud hands” movement follows the same principle; it habituates your brain to the movement of your hands.
Below are some optokinetic exercise videos.
This is a basic one:
- http://dizziness-and-balance.com/treatment/rehab/mdd/okn.php?arg1=50 (use the arrow keys to start the movement and control the speed)
These two are harder:
Once you are used to these, try this one:
The following playlists compile complex exercises: