Featuring Penny Gilpin, BScPT, FCAMPT
Treloar Physiotherapy, Vancouver BC
Duration: 3 minutes, 7 seconds

There are many causes of dizziness that can sometimes be challenging to diagnose.

Heart conditions, neurological conditions, sometimes people actually demonstrate a bit of imbalance when they’re getting out of the chair or walking across the room. Some people are sensitive to light, some people are sensitive to motion around them.

Viruses that can attack the inner ear, either the labyrinth, which is part of the inner ear, or the, the nerve that goes into the system. And that could be a recent virus or something that’s happened in the past.

And depending, again, on how acute it is or how long it’s been there, examining them is to try to sort out what movements they’re having trouble with.

Specific head movements, body movements, and the, the plan is to identify things that bring on the symptoms so that you can then put together an exercise program that will help the vestibular system compensate. Because usually you’re dealing with a loss in function of the vestibular system. So it’s very specific to the patient’s problem. That’s one problem or one presentation.

The other thing that’s similar to that is in the aging population, people that are older, their vestibular system is aging as well. And they commonly have dizzy symptoms and, and that would be managed much the same way, to try to determine what problems they’re having.

Specific to the aging population, though, is the, the issue of balance. Because balance issues with, with older people, there’s always a worry about fall.

A physiotherapist will treat benign positional vertigo by doing something called the Dix-Hallpike test, which you will, will do and, and try to reproduce the symptoms. If you can reproduce the symptoms and make them dizzy, you can use something called the Epley maneuver to reposition the crystals that cause the dizziness in the inner ear.

The Epley maneuver is a treatment where you position the head down into different positions, turn the head in three different positions, and then sit the patient back up. On retesting, we would do the same technique again and determine whether there was any remaining dizziness. It can be very effective. Often one or two treatments can fix the problem.

It’s important to rule out any heart conditions, neurological conditions, other things that might be feeding into the vestibular system. But as a physio, I more often am referred patients that might have inner ear or true vestibular problems.

And, and again, the most important thing is the, the assessment to try to figure out where that’s coming from. Many different things can affect the vestibular system. Concussions, any head or neck trauma, certain medications, as well as the normal aging process can, can lead to dizzy symptoms.

So it’s a matter of sorting out what might be feeding into the system and, and how they present on examination. So really critical to do a good examination.

Presenter: Ms. Penny Galpin, Physiotherapist, Vancouver, BC

Local Practitioners: Physiotherapist