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!)
A Full List of the Main Topics
Click on a main topic below. Sub-topics will come up. Click on a plus sign (+) to read more about each sub-topic.
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.
The balance system is complex and involves the brain analyzing and interpreting information from three major systems: the inner ear sensors for balance (vestibular system), the visual system, and the sensation that goes from the skin, muscles and joints (proprioceptive system).
Any sensation of dizziness and imbalance may result when one or more of these four parts are not functioning well. Therefore, the perceived asymmetries you experience may stem from the vestibular organs, from the proprioceptive system and/or from the brain’s processing of the their information. You did not mention visual issues, but treating these symptoms often involve also addressing the processing of visual information, with and without head movements.
You may wish to pursue assessments to clarify whether you do have asymmetries in your balance system, namely a vestibular assessment (for the inner ear sensors and their connections with eyes and brain) and a physiotherapy assessment, for the proprioceptive and musculo-skeletal systems. Proper treatment/rehabilitation can then be tailored to your needs.